3BG-23401-65126

4 vaccinations 10 coded responses 29 check-ins 10 free-text entries 5 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 038 / NH
Registered: 2021-05-29

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

Registered dependents

ZE5-20187-68032 Child or adolescent in my care · Female · 2021-06-26

Timeline

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

2021-03-22
Dose 1 — Moderna
2021-04-19
Dose 2 — Moderna
2021-05-29
Registered in v-safe
2021-05-29
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-31
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-19
Survey response — 3 months, dose 2
MedDRA: Fatigue, Headache, Pain — 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: Extra pain, headaches and fatigue.

MedDRA releases: 2024-11 · check-in free text available
2021-07-19
Report sent to call center — 3 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)
2021-07-27
Call 1 — Could Not Reach Participant
2021-07-30
Call 2 — Could Not Reach Participant
2021-10-18
Survey response — 6 months, dose 2
MedDRA: Hepatic enzyme increased, Neuropathy peripheral, Surgery, Thoracic outlet syndrome — 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: Neuropathy associated with thoracic outlet syndrome post surgery. Increase in liver enzymes

MedDRA releases: 2024-11 · check-in free text available
2021-10-18
Report sent to call center — 6 months, dose 2
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)
2021-10-20
Call 1 — Could Not Reach Participant
2021-10-23
Call 2 — Could Not Reach Participant
2021-12-15
Dose 3 — Pfizer-BioNTech
2021-12-18
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizziness, moderate

MedDRA releases: 2024-11 · check-in free text available
2021-12-19
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Fair · Muscle or body aches

Free text: Dizziness, mild

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness, mild

MedDRA releases: 2024-11 · check-in free text available
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-22
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-12-29
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-07
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-01-12
Survey response — day 28, dose 3
MedDRA: Cough, Fatigue, Insomnia, Oropharyngeal pain, Respiratory tract congestion — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Continuing cough, sore throat and congestion with extreme fatigue and insomnia

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
Report sent to call center — day 28, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-13
Call 1 — Could Not Reach Participant
2022-01-18
Call 2 — Could Not Reach Participant
2022-01-19
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-28
Survey response — day 42, dose 3
MedDRA: Diarrhoea — 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, Outpatient clinic or urgent care clinic visit

Free text: Constant Diahhrea

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Report sent to call center — day 42, 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-16
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-17
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-10-14
Dose 4 — Pfizer-BioNTech
2022-10-15
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizzy/lightheadedness

MedDRA releases: 2024-11 · check-in free text available
2022-10-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-10-17
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains

Adult check-in
2022-10-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-19
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-10-21
Health check-in — day 7, dose 4
Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2022-10-28
Survey response — day 14, dose 4
MedDRA: Arthralgia, Diaphragmalgia, Menstrual disorder, Migraine, Myalgia, Pain, Pelvic pain — 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, Outpatient clinic or urgent care clinic visit

Free text: Pain throughout my body including joints, muscles, diaphragm, and pelvic pain. Abnormal menstrual bleeding and migration headaches.

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Report sent to call center — day 14, dose 4
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 · 1 call case(s)
2022-10-31
Call successful
Participant prefers to complete VAERS report online
2022-11-04
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-11-13
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-11-18
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-25
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-01-13
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-14
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-19	Moderna
3	2021-12-15	Pfizer-BioNTech	No
4	2022-10-14	Pfizer-BioNTech	No

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 9 — 3 months, dose 2

2021-07-19

Symptoms: Extra pain, headaches and fatigue.

Release 10 — 6 months, dose 2

2021-10-18

Symptoms: Neuropathy associated with thoracic outlet syndrome post surgery. Increase in liver enzymes

Release 10 — days 1–6 daily, dose 3

2021-12-18

Systemic reaction (other): Dizziness, moderate

2021-12-19

Systemic reaction (other): Dizziness, mild

2021-12-20

Systemic reaction (other): Dizziness, mild

Release 10 — day 28, dose 3

2022-01-12

Symptoms: Continuing cough, sore throat and congestion with extreme fatigue and insomnia

Release 11 — day 42, dose 3

2022-01-28

Symptoms: Constant Diahhrea

Release 12 — days 1–6 daily, dose 4

2022-10-15

Systemic reaction (other): Dizzy/lightheadedness

2022-10-19

Systemic reaction (other): Sore throat

Release 12 — day 14, dose 4

2022-10-28

Symptoms: Pain throughout my body including joints, muscles, diaphragm, and pelvic pain. Abnormal menstrual bleeding and migration headaches.

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	Arthralgia	·	·	✓
SD	Cough	·	·	✓
SD	Diaphragmalgia	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Hepatic enzyme increased	·	·	✓
SD	Insomnia	·	·	✓
SD	Menstrual disorder	·	·	✓
SD	Migraine	·	·	✓
SD	Myalgia	·	·	✓
SD	Neuropathy peripheral	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pelvic pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Surgery	·	·	✓
SD	Thoracic outlet syndrome	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Oropharyngeal pain	·	·	✓

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