Z6H-15952-93952

5 vaccinations 7 coded responses 33 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 240 / VA
Registered: 2021-01-31

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

2021-01-30
Dose 1 — Pfizer-BioNTech
2021-01-31
Registered in v-safe
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache

Free text: No other symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-20
Dose 2 — Pfizer-BioNTech
2021-02-20
Health check-in — day 0, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Joint pains

Adult check-in
2021-02-27
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Survey response — day 14, dose 2
MedDRA: Fatigue, Headache — Feeling: Good

Free text: Headaches yesterday and today, did not limit activity. Minor fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-23
Survey response — 3 months, dose 2
MedDRA: Abdominal pain, Cough, Office visit, Pre-existing disease, Seasonal allergy, Unevaluable event, Weight decreased, Wheezing — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Abdominal pain, and wt loss; had CT, to have upper, lower GI. Cough, wheeze, seem related to seasonal allergies. · Healthcare visit (other): Follow-up w dr, test, as above

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-19
Dose 3 — Pfizer-BioNTech
2021-08-21
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Resurgence of GI issues, which had been experienced before receiving vaccines.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-21
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-24
Call 1 — Left Voicemail
2021-10-01
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-11-18
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-02-17
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-02-25
Dose 4 — Pfizer-BioNTech
2022-08-26
Survey response — 6 months, dose 4
MedDRA: Cardiac disorder, Office visit, Weight decreased — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Reemergence of heart issues. Continued wt loss. · Healthcare visit (other): Regular appointment with cardiologist, GI follow-up, etc.

MedDRA releases: 2024-11 · check-in free text available
2022-08-26
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-29
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-22
Dose 5 — Pfizer-BioNTech
2022-10-03
Survey response — day 7, dose 5
MedDRA: Arthralgia, Pre-existing disease — Feeling: Good · Joint pains

Free text: Hip pain related to arthritis

MedDRA releases: 2024-11 · check-in free text available
2022-10-06
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-13
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-20
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-03
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-22
Survey response — 3 months, dose 5
MedDRA: Cough, Decreased appetite, Laryngitis, Oropharyngeal pain, Respiratory tract infection viral, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Laryngitis, cough. Began with sore throat morning of 12/19. Dr says symptoms a respiratory virus. Testing negative for covid. Appetite some better tday.

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Report sent to call center — 3 months, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-12-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-23
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Pfizer-BioNTech
2	2021-02-20	Pfizer-BioNTech
3	2021-08-19	Pfizer-BioNTech	No
4	2022-02-25	Pfizer-BioNTech	No
5	2022-09-22	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-23	Successful 2022-12-23	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-08-21	Successful 2022-12-23	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-26	Successful 2022-08-29	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-22	Successful 2022-12-23	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-02

Systemic reaction (other): No other symptoms

Release 5 — day 14, dose 2

2021-03-06

Symptoms: Headaches yesterday and today, did not limit activity. Minor fatigue.

Release 8 — 3 months, dose 2

2021-05-23

Symptoms: Abdominal pain, and wt loss; had CT, to have upper, lower GI. Cough, wheeze, seem related to seasonal allergies.

Healthcare visit (other): Follow-up w dr, test, as above

Release 9 — 6 months, dose 2

2021-08-21

Symptoms: Resurgence of GI issues, which had been experienced before receiving vaccines.

Release 12 — 6 months, dose 4

2022-08-26

Symptoms: Reemergence of heart issues. Continued wt loss.

Healthcare visit (other): Regular appointment with cardiologist, GI follow-up, etc.

Release 12 — day 7, dose 5

2022-10-03

Systemic reaction (other): Hip pain related to arthritis

Release 12 — 3 months, dose 5

2022-12-22

Symptoms: Laryngitis, cough. Began with sore throat morning of 12/19. Dr says symptoms a respiratory virus. Testing negative for covid. Appetite some better tday.

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
HCVO	Office visit	·	·	✓
HCVO	Unevaluable event	✓	✓	○
SD	Abdominal pain	✓	✓	✓
SD	Cardiac disorder	·	·	✓
SD	Condition aggravated	✓	·	✓
SD	Cough	✓	✓	✓
SD	Decreased appetite	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Laryngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Respiratory tract infection viral	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Seasonal allergy	✓	✓	○
SD	Weight decreased	✓	✓	✓
SD	Wheezing	✓	✓	✓
SRO	Arthralgia	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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