ZTP-20886-05783

5 vaccinations 4 coded responses 41 check-ins 4 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 462 / IN
Registered: 2021-01-02

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

2021-01-02
Registered in v-safe
2021-01-02
Dose 1 — Pfizer-BioNTech
2021-01-02
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Nausea — Feeling: Fair · Nausea

Free text: Just slight nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-23
Survey response — day 21, dose 1
MedDRA: Dizziness, Ear infection, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I believe I have an ear infection. I am experiencing dizziness when I turn on my right side or bend over. I have had this before and have an appointment with PCP on Tues. I get 2nd vaccine on Monday the 25th · Healthcare visit (other): Seeing PCP in office on 1/26/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-25
Dose 2 — Pfizer-BioNTech
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Chills, Fatigue, Headache — Feeling: Good · Site: Pain, Redness, Itching · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Not today but on 1/26/21 I had severe chills, headache and fatigue and weakness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · None · Be unable to work

Adult check-in
2021-02-02
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Redness, Itching · None · Be unable to work

Adult check-in
2021-02-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-02
Call 1 — Left Voicemail
2021-04-02
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-04-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-01
Dose 3 — Pfizer-BioNTech
2021-10-01
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Headache, Fatigue or tiredness

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 — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-08
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-15
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-22
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-29
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-05
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-31
Survey response — 3 months, dose 3
MedDRA: Exposure to SARS-CoV-2, Malaise — Feeling: Poor · 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: I was exposed to Covid a week ago and yesterday evening I started experiencing symptoms

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Report sent to call center — 3 months, dose 3
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)
2022-01-04
Call 1 — Could Not Reach Participant
2022-01-10
Call 2 — Could Not Reach Participant
2022-04-01
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-21
Dose 4 — Pfizer-BioNTech
2022-05-15
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-26
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-02
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-21
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-20
Dose 5 — Pfizer-BioNTech
2022-10-20
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-02	Pfizer-BioNTech
2	2021-01-25	Pfizer-BioNTech
3	2021-10-01	Pfizer-BioNTech	No
4	2022-04-21	Pfizer-BioNTech	No
5	2022-09-20	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-23	Successful 2021-04-02	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-31	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-03

Systemic reaction (other): Just slight nausea

Release 2 — day 21, dose 1

2021-01-23

Symptoms: I believe I have an ear infection. I am experiencing dizziness when I turn on my right side or bend over. I have had this before and have an appointment with PCP on Tues. I get 2nd vaccine on Monday the 25th

Healthcare visit (other): Seeing PCP in office on 1/26/21

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): Not today but on 1/26/21 I had severe chills, headache and fatigue and weakness.

Release 10 — 3 months, dose 3

2021-12-31

Symptoms: I was exposed to Covid a week ago and yesterday evening I started experiencing symptoms

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	Dizziness	✓	✓	✓
SD	Ear infection	✓	✓	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Malaise	·	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Nausea	✓	✓	✓

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