Z6A-18824-39824

4 vaccinations 8 coded responses 46 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 530 / WI
Registered: 2021-01-14

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Pfizer-BioNTech
2021-01-14
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Pfizer-BioNTech
2021-02-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain, Musculoskeletal chest pain, Musculoskeletal pain, Pain — Feeling: Good · Site: Pain, Swelling

Free text: Pain went from injection site down my arm and down the side of my rib cage and scapula.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Abdominal pain

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Diarrhea

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — day 14, dose 2
MedDRA: Chills, Nausea — Feeling: Good

Free text: Last night i had nausea and chills with no temperature. It stayed about 9 pm and last until about 3 am. No other symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — day 21, dose 2
MedDRA: Malaise, Nausea — Feeling: Fair

Free text: Last night felt nauseated. Today dint feel well in bevel. This is the only time I've felt ill since last week.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-08
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-28
Dose 3 — Pfizer-BioNTech
2021-10-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches

Adult check-in
2021-10-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-14
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-28
Survey response — 3 months, dose 3
MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain, Rhinorrhoea, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Cold symptoms: runny nose, sore throat, slight cough. Diagnosed with sinus infection

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-30
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-10
Dose 4 — Pfizer-BioNTech
2022-05-15
Survey response — days 1–6 daily, dose 4
MedDRA: COVID-19 — Feeling: Poor · Headache, Fatigue or tiredness

Free text: I was diagnosed with covid this morning

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Survey response — days 1–6 daily, dose 4
MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school

Free text: Head congestion and runny noise

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Survey response — day 7, dose 4
MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Head Congestion and runny noise

MedDRA releases: 2024-11 · check-in free text available
2022-05-24
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-31
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-07
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-14
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-21
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-10
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-12
Survey response — 12 months, dose 4
MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-05-12
Report sent to call center — 12 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-05-15
Call 1 — Requested Callback
2023-05-16
Call 2 — Left Voicemail
2023-05-16
Callback requested for
02:00PM ET

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Pfizer-BioNTech
2	2021-02-04	Pfizer-BioNTech
3	2021-09-28	Pfizer-BioNTech	No
4	2022-05-10	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-12-28	Successful 2021-12-30	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2023-05-12	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Pain went from injection site down my arm and down the side of my rib cage and scapula.

Release 4 — day 14, dose 2

2021-02-18

Symptoms: Last night i had nausea and chills with no temperature. It stayed about 9 pm and last until about 3 am. No other symptoms.

Release 4 — day 21, dose 2

2021-02-25

Symptoms: Last night felt nauseated. Today dint feel well in bevel. This is the only time I've felt ill since last week.

Release 10 — 3 months, dose 3

2021-12-28

Symptoms: Cold symptoms: runny nose, sore throat, slight cough. Diagnosed with sinus infection

Release 11 — days 1–6 daily, dose 4

2022-05-15

Systemic reaction (other): I was diagnosed with covid this morning

2022-05-16

Systemic reaction (other): Head congestion and runny noise

Release 11 — day 7, dose 4

2022-05-17

Systemic reaction (other): Head Congestion and runny noise

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
SD	Chills	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Malaise	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinusitis	·	·	✓
SRO	COVID-19	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Musculoskeletal chest pain	✓	✓	✓
SRO	Musculoskeletal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Rhinorrhoea	·	·	✓

✓ active code · ○ coded but marked inactive · blank = not in that release