7LD-19224-70777

4 vaccinations 5 coded responses 50 check-ins 5 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 125 / NY
Registered: 2021-04-06

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

4TN-20478-75913 Child or adolescent in my care · Female · 2022-06-27

B3V-23591-64390 Child or adolescent in my care · Male · 2023-01-17

Timeline

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

2021-04-05
Dose 1 — Pfizer-BioNTech
2021-04-06
Registered in v-safe
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-26
Dose 2 — Pfizer-BioNTech
2021-04-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lack of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Headache

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-05-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-26
Survey response — 3 months, dose 2
MedDRA: Abortion spontaneous, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I had a miscarriage at 9 weeks, 4 days · Healthcare visit (other): Saw my OBGYN, had ultrasounds

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-26
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-27
Call 1 — Left Voicemail
2021-07-27
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-28
Dose 3 — Moderna
2021-12-28
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-29
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-01-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2022-01-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2022-01-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2022-01-04
Health check-in — day 7, dose 3
Feeling: Good · Joint pains

Adult check-in
2022-01-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-18
Survey response — day 21, dose 3
MedDRA: Musculoskeletal stiffness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Stiff neck

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-08
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-29
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-28
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-09
Dose 4 — Moderna
Co-administered: Flu
2022-09-09
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-10
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-09-11
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fever · Muscle or body aches

Adult check-in
2022-09-16
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-09-23
Survey response — day 14, dose 4
MedDRA: Surgery, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Several irrelevant to the vaccine. · Healthcare visit (other): Outpatient surgery

MedDRA releases: 2024-11 · check-in free text available
2022-09-23
Report sent to call center — day 14, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-09-26
Call successful
Not applicable - Accidental Reporting
2022-09-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-07
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-14
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-21
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-09
Survey response — 3 months, dose 4
MedDRA: Malaise, Nasopharyngitis, Pharyngitis streptococcal — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sick, a cold or strept

MedDRA releases: 2024-11 · check-in free text available
2023-03-10
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-05	Pfizer-BioNTech
2	2021-04-26	Pfizer-BioNTech
3	2021-12-28	Moderna	No
4	2022-09-09	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-07-26	Successful 2021-07-27	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-09-23	Successful 2022-09-26	Not applicable - Accidental Reporting

Free text

Release 8 — days 1–6 daily, dose 2

2021-04-27

Systemic reaction (other): Lack of appetite

Release 9 — 3 months, dose 2

2021-07-26

Symptoms: I had a miscarriage at 9 weeks, 4 days

Healthcare visit (other): Saw my OBGYN, had ultrasounds

Release 10 — day 21, dose 3

2022-01-18

Symptoms: Stiff neck

Release 12 — day 14, dose 4

2022-09-23

Symptoms: Several irrelevant to the vaccine.

Healthcare visit (other): Outpatient surgery

Release 12 — 3 months, dose 4

2022-12-09

Symptoms: Sick, a cold or strept

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
HCVO	Office visit	✓	·	✓
HCVO	Surgery	·	·	✓
SD	Abortion spontaneous	✓	·	✓
SD	Malaise	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pharyngitis streptococcal	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Decreased appetite	✓	✓	✓

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