6C3-22783-04472
4 vaccinations
3 coded responses
14 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 945 / CA
- Registered
- 2022-06-15
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Registered dependents
KAM-18419-43481
Child or adolescent in my care · Female · 2022-06-15
MEY-22511-22022
Child or adolescent in my care · Female · 2022-07-08
Timeline
-
2021-03-11
Dose 1 — Janssen/Johnson & Johnson
-
2021-07-22
Dose 2 — Pfizer-BioNTech
-
2021-08-12
Dose 3 — Pfizer-BioNTech
-
2022-06-15
Registered in v-safe
-
2022-08-12
Survey response — 12 months, dose 3MedDRA: Nausea, Pregnancy, Vomiting — 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 · Outpatient clinic or urgent care clinic visitFree text: Severe nausea and vomiting associated with pregnancy.MedDRA releases: 2024-11 · check-in free text available
-
2022-08-12
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-08-15
-
2022-09-10
Dose 4 — ModernaCo-administered: Flu
-
2022-09-11
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-09-12
- 2022-09-13
- 2022-09-14
- 2022-09-16
- 2022-09-17
- 2022-09-24
- 2022-10-01
- 2022-10-10
-
2022-10-15
Survey response — day 35, dose 4MedDRA: Influenza virus test negative, Respiratory tract infection viral, SARS-CoV-2 test negative, Sinusitis — 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 visitFree text: Viral respiratory/sinus infection (confirmed not COVID or flu)MedDRA releases: 2024-11 · check-in free text available
-
2022-10-15
Report sent to call center — day 35, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-10-18
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-18
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-22
-
2022-12-10
Survey response — 3 months, dose 4MedDRA: Nasopharyngitis — Feeling: FairFree text: I have a cold.MedDRA releases: 2024-11 · check-in free text available
- 2023-03-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Janssen/Johnson & Johnson | No |
| 2 | 2021-07-22 | Pfizer-BioNTech | No |
| 3 | 2021-08-12 | Pfizer-BioNTech | No |
| 4 | 2022-09-10 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-08-12 | Successful 2022-10-18 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-10-15 | Successful 2022-10-18 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — 12 months, dose 3
Symptoms: Severe nausea and vomiting associated with pregnancy.
Release 12 — day 35, dose 4
Symptoms: Viral respiratory/sinus infection (confirmed not COVID or flu)
Release 12 — 3 months, dose 4
Symptoms: I have a cold.
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 | Influenza virus test negative | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Respiratory tract infection viral | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release