ZSS-21623-93727

4 vaccinations 5 coded responses 36 check-ins 4 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 200 / DC
Registered: 2021-03-21

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

Registered dependents

EDT-12865-61861 Child or adolescent in my care · Female · 2022-06-29

45K-13065-03645 Child or adolescent in my care · Female · 2023-04-07

Timeline

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

2021-03-21
Registered in v-safe
2021-03-21
Dose 1 — Pfizer-BioNTech
2021-03-21
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-11
Dose 2 — Pfizer-BioNTech
2021-04-11
Health check-in — day 0, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-10-10
Survey response — 6 months, dose 2
MedDRA: Nasopharyngitis — Feeling: Good

Free text: I had a cold

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Dose 3 — Pfizer-BioNTech
2022-04-11
Survey response — 12 months, dose 2
MedDRA: Office visit, Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Pregnancy with due date 10/2/22 · Healthcare visit (other): Standard prenatal care

MedDRA releases: 2024-11 · check-in free text available
2022-04-11
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-13
Call successful
Does not wish to fill out VAERS report
2022-09-09
Dose 4 — Pfizer-BioNTech
2022-09-09
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-09-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-16
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-09-23
Survey response — day 14, dose 4
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Poor · Be unable to do your normal daily activities

Free text: Cold symptoms (pcr negative for Covid)

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-07
Survey response — day 28, dose 4
MedDRA: Delivery — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Gave birth · Healthcare visit (other): Gave birth

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
Report sent to call center — day 28, 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

Hospitalization · 1 call case(s)
2022-10-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-14
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-23
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-10
Survey response — 6 months, dose 4
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-21	Pfizer-BioNTech
2	2021-04-11	Pfizer-BioNTech
3	2021-12-13	Pfizer-BioNTech	No
4	2022-09-09	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-04-11	Successful 2022-04-13	Does not wish to fill out VAERS report
2022-10-07	Successful 2022-10-10	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 10 — 6 months, dose 2

2021-10-10

Symptoms: I had a cold

Release 11 — 12 months, dose 2

2022-04-11

Symptoms: Pregnancy with due date 10/2/22

Healthcare visit (other): Standard prenatal care

Release 12 — day 14, dose 4

2022-09-23

Symptoms: Cold symptoms (pcr negative for Covid)

Release 12 — day 28, dose 4

2022-10-07

Symptoms: Gave birth

Healthcare visit (other): Gave birth

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	Delivery	·	·	✓
HCVO	Office visit	·	·	✓
SD	COVID-19	·	·	✓
SD	Delivery	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pregnancy	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓

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