5LD-27918-32707

4 vaccinations 5 coded responses 30 check-ins 5 free-text entries 2 call cases

Sex: Male
Age at first dose: 05-11
ZIP prefix: 070 / NJ
Registered: 2021-11-07

Relationship: Child or adolescent in my care
Guardian: 4Z3-33930-68266
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-11-07
Registered in v-safe
2021-11-08
Dose 1 — Pfizer-BioNTech
2021-11-08
Health check-in — day 0, dose 1, dependent
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-11-11
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-12
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-13
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Dry eye — Feeling: Good · Headache

Free text: Dry eyes

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Health check-in — day 7, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-22
Health check-in — day 14, dose 1, dependent
Feeling: Good

Adult check-in
2021-11-29
Dose 2 — Pfizer-BioNTech
2021-11-29
Health check-in — day 0, dose 2, dependent
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-12-01
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Axillary pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Pain in the armpit on the side of injection

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-06
Health check-in — day 7, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-14
Health check-in — day 14, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-28
Health check-in — day 28, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-03
Health check-in — day 35, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-10
Survey response — day 42, dose 2, dependent
MedDRA: Headache, Oropharyngeal pain, Pyrexia, Rhinorrhoea — 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

Free text: Fever, sore throat, runny nose, headache

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Report sent to call center — day 42, dose 2, dependent
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 · 1 call case(s)
2022-01-11
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-30
Dose 3 — Pfizer-BioNTech
2022-05-01
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-04
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Cough — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2022-05-07
Survey response — day 7, dose 3, dependent
MedDRA: Cough, Rhinorrhoea — Feeling: Fair · Fever · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Coughing, runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-05-07
Report sent to call center — day 7, dose 3, dependent
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-14
Health check-in — day 14, dose 3, dependent
Feeling: Fair

Adult check-in
2022-05-23
Health check-in — day 21, dose 3, dependent
Feeling: Good

Adult check-in
2022-05-28
Health check-in — day 28, dose 3, dependent
Feeling: Good

Adult check-in
2022-06-04
Health check-in — day 35, dose 3, dependent
Feeling: Good

Adult check-in
2022-06-11
Health check-in — day 42, dose 3, dependent
Feeling: Good

Adult check-in
2022-12-16
Dose 4 — Moderna
2022-12-17
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-12-19
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-12-20
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2022-12-22
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · None

Adult check-in
2022-12-30
Health check-in — day 14, dose 4, dependent
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-11-08	Pfizer-BioNTech	No
2	2021-11-29	Pfizer-BioNTech	No
3	2022-04-30	Pfizer-BioNTech	No
4	2022-12-16	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 10 — days 1–6 daily, dose 1, dependent

2021-11-13

Systemic reaction (other): Dry eyes

Release 10 — days 1–6 daily, dose 2, dependent

2021-12-01

Systemic reaction (other): Pain in the armpit on the side of injection

Release 10 — day 42, dose 2, dependent

2022-01-10

Symptoms: Fever, sore throat, runny nose, headache

Release 11 — days 1–6 daily, dose 3, dependent

2022-05-04

Systemic reaction (other): Cough

Release 11 — day 7, dose 3, dependent

2022-05-07

Systemic reaction (other): Coughing, runny nose

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	Headache	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Cough	·	·	✓
SRO	Dry eye	·	·	✓
SRO	Rhinorrhoea	·	·	✓

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