4JC-28503-29063

4 vaccinations 7 coded responses 29 check-ins 7 free-text entries 5 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 060 / CT
Registered: 2021-03-21

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

2021-02-28
Dose 1 — Pfizer-BioNTech
2021-03-21
Registered in v-safe
2021-03-21
Dose 2 — Pfizer-BioNTech
2021-03-21
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-24
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Headache

Free text: Lightheadedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Diarrhea

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Diarrhea

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — day 7, dose 2
Feeling: Good · None

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

Adult check-in
2021-04-11
Survey response — day 21, dose 2
MedDRA: Migraine — 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: Ive had 4 migraines in a month since receiving my first vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-19
Survey response — 6 months, dose 2
MedDRA: Blepharitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Diagnosed with blepharitis

MedDRA releases: 2024-11 · check-in free text available
2021-09-19
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-20
Call 1 — Left Voicemail
2021-11-04
Dose 3 — Moderna
2022-03-21
Survey response — 12 months, dose 2
MedDRA: COVID-19, Pregnancy — 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: Pregnancy Covid

MedDRA releases: 2024-11 · check-in free text available
2022-03-21
Report sent to call center — 12 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-03-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-03-28
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-05
Survey response — 6 months, dose 3
MedDRA: Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-06
Call 1 — Left Voicemail
2022-09-27
Dose 4 — Moderna
Co-administered: Flu
2022-09-28
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-09-29
Survey response — days 1–6 daily, dose 4
MedDRA: Constipation — Feeling: Fair · Site: Pain · Headache

Free text: Constipation

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-04
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-18
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-25
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: Birth of a baby

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
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)
2022-10-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-01
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-11-10
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-27
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-28
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-28	Pfizer-BioNTech
2	2021-03-21	Pfizer-BioNTech
3	2021-11-04	Moderna	No
4	2022-09-27	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-04-11	Successful 2022-03-28	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-19	Successful 2022-03-28	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-03-21	Successful 2022-03-28	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-05	Successful 2022-10-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-25	Successful 2022-10-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-24

Systemic reaction (other): Lightheadedness

Release 7 — day 21, dose 2

2021-04-11

Symptoms: Ive had 4 migraines in a month since receiving my first vaccine

Release 9 — 6 months, dose 2

2021-09-19

Symptoms: Diagnosed with blepharitis

Release 11 — 12 months, dose 2

2022-03-21

Symptoms: Pregnancy Covid

Release 11 — 6 months, dose 3

2022-05-05

Symptoms: Pregnancy

Release 12 — days 1–6 daily, dose 4

2022-09-29

Systemic reaction (other): Constipation

Release 12 — day 28, dose 4

2022-10-25

Symptoms: Birth of a baby

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	Blepharitis	·	·	✓
SD	COVID-19	·	·	✓
SD	Delivery	·	·	✓
SD	Migraine	✓	✓	✓
SD	Pregnancy	·	·	✓
SRO	Constipation	·	·	✓
SRO	Dizziness	✓	✓	✓

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