Z92-29164-20387

6 vaccinations 3 coded responses 24 check-ins 3 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 280 / NC
Registered: 2021-01-23

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

2021-01-23
Registered in v-safe
2021-01-23
Dose 1 — Pfizer-BioNTech
2021-01-23
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-13
Dose 2 — Pfizer-BioNTech
2021-02-20
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-15
Survey response — 3 months, dose 2
MedDRA: Feeling abnormal, SARS-CoV-2 test negative, Sinusitis — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Have had allergies since end of March that went in to sinus infection. Rapid tested negative for Covid 3 times in last six weeks. On my second antibiotic and still feel bad.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-12
Dose 3 — Pfizer-BioNTech
2022-02-13
Dose 4 — Pfizer-BioNTech
2022-02-13
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-08
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-27
Dose 5 — Pfizer-BioNTech
2022-09-16
Dose 6 — Pfizer-BioNTech
2022-10-05
Survey response — day 14, dose 6
MedDRA: COVID-19, Chills, Headache, Oropharyngeal pain, Pain, SARS-CoV-2 test positive, Sinus pain, Sneezing, Vomiting — 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 · Outpatient clinic or urgent care clinic visit

Free text: Covid positive 9-24 sore throat body aches headache chills throwing up Day 3 improving Day 10 home test still positive Day 11 sinuses hurt headache Day 12 home in bed sneezing new symptom

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Report sent to call center — day 14, dose 6
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-07
Survey response — day 21, dose 6
MedDRA: Back pain, COVID-19, Cough, Fatigue, Headache, Illness, Infection, SARS-CoV-2 test positive, Sneezing — Feeling: Poor · Be unable to work or attend school, 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: Day 13 of Covid new symptom sneezing and dry cough 12am woke up coughed 3 hrs. Started with head/back ache fatigue UC tested positive for Covid and secondary infection. Treatment is for Acute Medical Illness

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
Report sent to call center — day 21, dose 6
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-10
Call 1 — Left Voicemail
2022-10-14
Health check-in — day 28, dose 6
Feeling: Good

Adult check-in
2022-10-21
Health check-in — day 35, dose 6
Feeling: Good

Adult check-in
2022-10-28
Health check-in — day 42, dose 6
Feeling: Good

Adult check-in
2022-12-17
Health check-in — 3 months, dose 6
Feeling: Good

Adult check-in
2023-03-17
Health check-in — 6 months, dose 6
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-23	Pfizer-BioNTech
2	2021-02-13	Pfizer-BioNTech
3	2021-10-12	Pfizer-BioNTech	No
4	2022-02-13	Pfizer-BioNTech	No
5	2022-04-27	Pfizer-BioNTech	No
6	2022-09-16	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-15	Successful 2022-04-08	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-10-05	Successful 2022-10-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-07	Unsuccessful

Free text

Release 8 — 3 months, dose 2

2021-05-15

Symptoms: Have had allergies since end of March that went in to sinus infection. Rapid tested negative for Covid 3 times in last six weeks. On my second antibiotic and still feel bad.

Release 12 — day 14, dose 6

2022-10-05

Symptoms: Covid positive 9-24 sore throat body aches headache chills throwing up Day 3 improving Day 10 home test still positive Day 11 sinuses hurt headache Day 12 home in bed sneezing new symptom

Release 12 — day 21, dose 6

2022-10-07

Symptoms: Day 13 of Covid new symptom sneezing and dry cough 12am woke up coughed 3 hrs. Started with head/back ache fatigue UC tested positive for Covid and secondary infection. Treatment is for Acute Medical Illness

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	Back pain	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	·	·	✓
SD	Illness	·	·	✓
SD	Infection	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sinus pain	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Sneezing	·	·	✓
SD	Vomiting	·	·	✓

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