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5C8-53536-86258

3 vaccinations 13 coded responses 15 check-ins 12 free-text entries 0 call cases
Sex
Female
Age at first dose
46-50
ZIP prefix
262 / WV
Registered
2021-05-22
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
RQM-62744-04518 Child or adolescent in my care · Male · 2022-01-15

Timeline

  1. 2021-04-09
    Dose 1 — Pfizer-BioNTech
  2. 2021-05-14
    Dose 2 — Pfizer-BioNTech
  3. 2021-05-22
    Registered in v-safe
  4. 2021-05-22
    Survey response — day 7, dose 2
    MedDRA: Brain fog, Fatigue — Feeling: Fair · Site: Pain · Be unable to do your normal daily activities
    Free text: Tiredness and brain fogginess
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-05-28
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  6. 2021-06-04
    Survey response — day 21, dose 2
    MedDRA: Ageusia, Anosmia, Chest discomfort, Cough, Headache, Nasal disorder — Feeling: Poor
    Free text: No smell no taste 100.1 temp cough nasal issues headache chest tightness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-06-12
    Survey response — day 28, dose 2
    MedDRA: Brain fog, Cough, Headache — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Headache brain fogginess mild cough
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-06-20
    Survey response — day 35, dose 2
    MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Temp is unusually low 96.1. Unusually really tired.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-06-28
    Survey response — day 42, dose 2
    MedDRA: Brain fog, Feeling abnormal — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Just feel a little mentally off. As they say brain foggy.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-08-13
    Survey response — 3 months, dose 2
    MedDRA: Chest pain, Cough, Dyspnoea, Headache, Medical counselling, Memory impairment, Mental impairment, Myalgia — Feeling: Poor · Be unable to do your normal daily activities
    Free text: My dr says i need to see a cardiologist. Having headaches, muscle aches, coughing constantly. Cough so hard cant catch my breath & have chest pains from it. Cant think clearly and very forgetful.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  11. 2022-01-06
    Dose 3 — Moderna
  12. 2022-01-15
    Health check-in — day 7, dose 3
    Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  13. 2022-01-21
    Survey response — day 14, dose 3
    MedDRA: Diarrhoea, Headache, Joint stiffness, Pain, Vomiting — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Diarrhea, vomiting, body aches, headache, joint stiffness
    MedDRA releases: 2024-11 · check-in free text available
  14. 2022-01-27
    Survey response — day 21, dose 3
    MedDRA: Arthralgia, Myalgia — Feeling: Fair
    Free text: Muscle/joint achiness
    MedDRA releases: 2024-11 · check-in free text available
  15. 2022-02-03
    Survey response — day 28, dose 3
    MedDRA: Arthralgia, Diarrhoea, Fatigue, Headache, Myalgia, Nausea, Pain, Pyrexia, Rhinorrhoea, Sneezing, Vomiting — Feeling: Poor · Be unable to work or attend school
    Free text: Up & down Fever, diarrhea, body aches (muscle & joint), nausea & vomiting, headache, feeling extreme tiredness, sneezing, runny nose
    MedDRA releases: 2024-11 · check-in free text available
  16. 2022-02-10
    Survey response — day 35, dose 3
    MedDRA: Fatigue, Headache, Oropharyngeal pain, Pain — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Sore throat body achiness headache extreme tiredness
    MedDRA releases: 2024-11 · check-in free text available
  17. 2022-02-20
    Survey response — day 42, dose 3
    MedDRA: Body temperature increased, Diarrhoea, Fatigue, Headache, Mental impairment, Vomiting — Feeling: Poor · Be unable to work or attend school
    Free text: Vomiting, diarrhea, headache 100° fever Mentally off a little and very tired
    MedDRA releases: 2024-11 · check-in free text available
  18. 2022-04-07
    Survey response — 3 months, dose 3
    MedDRA: Abdominal pain upper, Diarrhoea, Gastroenteritis viral, Nausea, Pain in extremity, Vomiting — Feeling: Fair · Be unable to work or attend school
    Free text: Leg pain, diarrhea off & on, stomach pain, and nausea & vomiting off & on. He's had stomach bug symptoms off and on for the past 6 months.
    MedDRA releases: 2024-11 · check-in free text available
  19. 2023-01-08
    Survey response — 12 months, dose 3
    MedDRA: Diarrhoea, Fatigue, Headache, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities
    MedDRA releases: 2024-11

Vaccinations

DoseDateManufacturerCo-administered
12021-04-09Pfizer-BioNTech
22021-05-14Pfizer-BioNTech
32022-01-06Moderna No

Free text

Release 8 — day 7, dose 2

2021-05-22

Systemic reaction (other): Tiredness and brain fogginess

Release 8 — day 21, dose 2

2021-06-04

Symptoms: No smell no taste 100.1 temp cough nasal issues headache chest tightness

Release 9 — day 28, dose 2

2021-06-12

Symptoms: Headache brain fogginess mild cough

Release 9 — day 35, dose 2

2021-06-20

Symptoms: Temp is unusually low 96.1. Unusually really tired.

Release 9 — day 42, dose 2

2021-06-28

Symptoms: Just feel a little mentally off. As they say brain foggy.

Release 9 — 3 months, dose 2

2021-08-13

Symptoms: My dr says i need to see a cardiologist. Having headaches, muscle aches, coughing constantly. Cough so hard cant catch my breath & have chest pains from it. Cant think clearly and very forgetful.

Release 11 — day 14, dose 3

2022-01-21

Symptoms: Diarrhea, vomiting, body aches, headache, joint stiffness

Release 11 — day 21, dose 3

2022-01-27

Symptoms: Muscle/joint achiness

Release 11 — day 28, dose 3

2022-02-03

Symptoms: Up & down Fever, diarrhea, body aches (muscle & joint), nausea & vomiting, headache, feeling extreme tiredness, sneezing, runny nose

Release 11 — day 35, dose 3

2022-02-10

Symptoms: Sore throat body achiness headache extreme tiredness

Release 11 — day 42, dose 3

2022-02-20

Symptoms: Vomiting, diarrhea, headache 100° fever Mentally off a little and very tired

Release 11 — 3 months, dose 3

2022-04-07

Symptoms: Leg pain, diarrhea off & on, stomach pain, and nausea & vomiting off & on. He's had stomach bug symptoms off and on for the past 6 months.

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

FieldPreferred term2021-092023-042024-11
SDAbdominal pain upper · · ✓
SDAgeusia ✓ ✓ ✓
SDAnosmia ✓ ✓ ✓
SDArthralgia · · ✓
SDBody temperature increased · · ✓
SDBrain fog ✓ ✓ ✓
SDChest discomfort ✓ ✓ ✓
SDChest pain ✓ · ✓
SDCough ✓ ✓ ✓
SDDiarrhoea · · ✓
SDDyspnoea ✓ · ✓
SDFatigue ✓ ✓ ✓
SDFeeling abnormal ✓ ✓ ✓
SDGastroenteritis viral · · ✓
SDHeadache ✓ ✓ ✓
SDJoint stiffness · · ✓
SDMedical counselling ✓ · ✓
SDMemory impairment ✓ · ✓
SDMental impairment ✓ · ✓
SDMyalgia ✓ · ✓
SDNasal disorder ✓ ✓ ✓
SDNausea · · ✓
SDOropharyngeal pain · · ✓
SDPain · · ✓
SDPain in extremity · · ✓
SDPyrexia · · ✓
SDRhinorrhoea · · ✓
SDSneezing · · ✓
SDVomiting · · ✓
SROBrain fog ✓ ✓ ✓
SROFatigue ✓ ✓ ✓

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

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