ZLC-33256-89192

3 vaccinations 11 coded responses 28 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 902 / CA
Registered: 2021-02-16

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Registered dependents

SZ3-30058-67778 Adult relative or friend · Female · 2021-11-14

ZR2-23267-70568 Adult relative or friend · Female · 2021-11-21

Timeline

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

2021-02-16
Registered in v-safe
2021-02-16
Dose 1 — Pfizer-BioNTech
2021-02-16
Health check-in — day 0, dose 1
Feeling: Fair · Site: Itching · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion, Productive cough — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Productive cough, nasal congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 1
MedDRA: Productive cough — Feeling: Fair · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Productive cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — day 7, dose 1
MedDRA: Productive cough — Feeling: Fair · Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Productive cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-09
Dose 2 — Pfizer-BioNTech
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Productive cough — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to work

Free text: Productive cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness

Free text: Productive cough

Adult check-in · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Productive cough — Feeling: Fair · Site: Itching · Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Productive Cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — day 7, dose 2
MedDRA: Productive cough, Sinus pain — Feeling: Poor · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Sinus pain, productive cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 14, dose 2
MedDRA: Dyspnoea, Eye pruritus, Fatigue, Pruritus, Respiratory tract congestion, Rhinitis allergic, Sinus congestion, Sinus disorder, Sputum discoloured, Swelling face — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Increased shortness of breath, worsening fatigue, increase productive thick dark yellowish sputum, chest and sinus congestion, face swollem @ sinuses, allergic rhinitis, itchy eyes & skin

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — day 21, dose 2
MedDRA: Dyspnoea, Hypersomnia, Nasal congestion, Office visit, Peripheral swelling, Productive cough, Swelling, Swelling face — Feeling: Poor · Be unable to work, 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: Face, toes and fingers swollen. Nasal congestion, productive cough, hypersomonia, increased shortness of breath · Healthcare visit (other): I saw both a pulmonary specialist and allergy/ immun. MD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Report sent to call center — day 21, 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)
2021-04-06
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Poor

Adult check-in
2021-04-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-07
Call 1 — Left Voicemail
2021-06-08
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-09
Survey response — 6 months, dose 2
MedDRA: Sinusitis — 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, Outpatient clinic or urgent care clinic visit

Free text: Sinus infection

MedDRA releases: 2024-11 · check-in free text available
2021-09-09
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-10
Call 1 — Left Voicemail
2021-11-12
Dose 3 — Pfizer-BioNTech
2021-11-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling, Itching · None

Adult check-in
2021-11-15
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Productive cough — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Free text: Both productive & non productive cough increase from my baseline

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-03
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-12
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-17
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-24
Survey response — day 42, dose 3
MedDRA: Cough, Fatigue, Sinusitis, Urinary tract infection — 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: Fatigue, increase in cough, sinusitis, UTI

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Report sent to call center — day 42, dose 3
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)
2021-12-27
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-13
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-05-14
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-11-12
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-16	Pfizer-BioNTech
2	2021-03-09	Pfizer-BioNTech
3	2021-11-12	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-01	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-09	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-24	Successful 2021-12-27	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-21

Systemic reaction (other): Productive cough, nasal congestion

2021-02-22

Systemic reaction (other): Productive cough

Release 4 — day 7, dose 1

2021-02-23

Systemic reaction (other): Productive cough

Release 5 — days 1–6 daily, dose 2

2021-03-10

Systemic reaction (other): Productive cough

2021-03-15

Systemic reaction (other): Productive Cough

Release 5 — day 7, dose 2

2021-03-16

Systemic reaction (other): Sinus pain, productive cough

Release 6 — day 14, dose 2

2021-03-24

Symptoms: Increased shortness of breath, worsening fatigue, increase productive thick dark yellowish sputum, chest and sinus congestion, face swollem @ sinuses, allergic rhinitis, itchy eyes & skin

Release 6 — day 21, dose 2

2021-04-01

Symptoms: Face, toes and fingers swollen. Nasal congestion, productive cough, hypersomonia, increased shortness of breath

Healthcare visit (other): I saw both a pulmonary specialist and allergy/ immun. MD

Release 9 — 6 months, dose 2

2021-09-09

Symptoms: Sinus infection

Release 10 — days 1–6 daily, dose 3

2021-11-15

Systemic reaction (other): Both productive & non productive cough increase from my baseline

Release 10 — day 42, dose 3

2021-12-24

Symptoms: Fatigue, increase in cough, sinusitis, UTI

Release 12 — days 1–6 daily, dose 2

2021-03-11

Systemic reaction (other): Productive cough

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	✓	✓	✓
SD	Cough	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Eye pruritus	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hypersomnia	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Productive cough	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinitis allergic	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SD	Sinus disorder	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Sputum discoloured	✓	✓	✓
SD	Swelling	✓	✓	✓
SD	Swelling face	✓	✓	✓
SD	Urinary tract infection	·	·	✓
SRO	Cough	·	·	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Productive cough	✓	✓	✓
SRO	Sinus pain	✓	✓	✓

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