7YS-16042-95076

3 vaccinations 9 coded responses 31 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 484 / MI
Registered: 2021-07-31

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

Registered dependents

4VK-25789-74336 Child or adolescent in my care · Female · 2022-06-29

DMW-52049-00999 Child or adolescent in my care · Male · 2022-06-29

RST-18321-73387 Child or adolescent in my care · Male · 2022-06-29

Timeline

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

2021-07-31
Registered in v-safe
2021-07-31
Dose 1 — Pfizer-BioNTech
2021-07-31
Survey response — day 0, dose 1
MedDRA: Ear discomfort — Feeling: Good · Site: Pain · Headache

Free text: Mild right ear discomfort

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-01
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Sore arm at injection

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Diarrhea

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

Adult check-in
2021-08-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-07
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-08-14
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-08-21
Dose 2 — Pfizer-BioNTech
2021-08-21
Survey response — day 0, dose 2
MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Headache

Free text: Sore arm

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-24
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-25
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain

Free text: Mild sore throat

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-08-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-08-28
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-09-04
Survey response — day 14, dose 2
MedDRA: Fatigue, Nasopharyngitis, Oropharyngeal pain — Feeling: Good

Free text: Sore throat, tiredness, mild head cold sensation.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-09-20
Survey response — day 28, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-09-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-10-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-11-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-02-19
Survey response — 6 months, dose 2
MedDRA: Emergency care, Hospitalisation, Small size placenta, Twin pregnancy — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Pregnant w/ twins when I received COVID vaccine. Delivered twins (b)(6) @ 38 weeks - discovered to have very small placentas indicative of maternal vascular malperfusion. Concern for cerebral palsy in twins due to findings. Is it vaccine related? · Healthcare visit (other): Many visits for twins due to CP concerns including ER and inpatient stays

MedDRA releases: 2024-11 · check-in free text available
2022-02-19
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-22
Call 1 — Left Voicemail
2022-08-10
Dose 3 — Moderna
2022-08-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-08-25
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-08-31
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-09-07
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-09-16
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-09-21
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-11-11
Survey response — 3 months, dose 3
MedDRA: Cough, Ear infection, Pyrexia, Respiratory syncytial virus infection, Tympanic membrane perforation — 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 visit

Free text: RSV, ruptured ear drum from ear infection, cough, fever

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Report sent to call center — 3 months, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-14
Call 2 — Left Voicemail
2022-11-14
Call 1 — Left Voicemail
2023-02-10
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-31	Pfizer-BioNTech	No
2	2021-08-21	Pfizer-BioNTech	No
3	2022-08-10	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 9 — day 0, dose 1

2021-07-31

Systemic reaction (other): Mild right ear discomfort

Release 9 — days 1–6 daily, dose 1

2021-08-01

Systemic reaction (other): Sore arm at injection

Release 9 — day 0, dose 2

2021-08-21

Systemic reaction (other): Sore arm

Release 9 — days 1–6 daily, dose 2

2021-08-24

Systemic reaction (other): Sore throat

2021-08-25

Systemic reaction (other): Mild sore throat

Release 9 — day 14, dose 2

2021-09-04

Symptoms: Sore throat, tiredness, mild head cold sensation.

Release 9 — day 28, dose 2

2021-09-20

Symptoms: Sore throat

Release 11 — 6 months, dose 2

2022-02-19

Symptoms: Pregnant w/ twins when I received COVID vaccine. Delivered twins (b)(6) @ 38 weeks - discovered to have very small placentas indicative of maternal vascular malperfusion. Concern for cerebral palsy in twins due to findings. Is it vaccine related?

Healthcare visit (other): Many visits for twins due to CP concerns including ER and inpatient stays

redacted (b)(6)

Release 12 — 3 months, dose 3

2022-11-11

Symptoms: RSV, ruptured ear drum from ear infection, cough, fever

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	Emergency care	·	·	✓
HCVO	Hospitalisation	·	·	✓
SD	Cough	·	·	✓
SD	Ear infection	·	·	✓
SD	Fatigue	✓	·	✓
SD	Nasopharyngitis	✓	·	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory syncytial virus infection	·	·	✓
SD	Small size placenta	·	·	✓
SD	Twin pregnancy	·	·	✓
SD	Tympanic membrane perforation	·	·	✓
SRO	Ear discomfort	✓	·	✓
SRO	Injection site pain	✓	·	✓
SRO	Oropharyngeal pain	✓	·	✓
SRO	Pain in extremity	✓	·	✓

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