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6JM-31373-06694

3 vaccinations 0 coded responses 15 check-ins 0 free-text entries 1 call case
Sex
Female
Age at first dose
36-40
ZIP prefix
073 / NJ
Registered
2021-11-30
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-12
    Dose 1 — Pfizer-BioNTech
  2. 2021-04-02
    Dose 2 — Pfizer-BioNTech
  3. 2021-11-30
    Registered in v-safe
  4. 2021-11-30
    Dose 3 — Moderna
  5. 2021-11-30
    Health check-in — day 0, dose 3
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  6. 2021-12-01
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · 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
    Adult check-in
  7. 2021-12-01
    Report sent to call center — days 1–6 daily, 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 · 1 call case(s)
  8. 2021-12-02
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Headache, Fatigue or tiredness
    Adult check-in
  9. 2021-12-03
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  10. 2021-12-04
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  11. 2021-12-06
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  12. 2021-12-07
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  13. 2021-12-07
  14. 2021-12-07
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  15. 2021-12-14
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  16. 2021-12-21
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  17. 2021-12-28
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  18. 2022-01-04
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  19. 2022-01-11
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  20. 2022-03-01
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  21. 2022-05-31
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  22. 2022-12-02
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-12Pfizer-BioNTech No
22021-04-02Pfizer-BioNTech No
32021-11-30Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-12-01 Successful
2021-12-07
 Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

None.

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

No MedDRA codes.

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