9VW-34581-06469

4 vaccinations 8 coded responses 35 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 607 / IL
Registered: 2021-02-20

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

Registered dependents

AWR-27116-40529 Child or adolescent in my care · Male · 2022-06-24

ELS-14460-24126 Child or adolescent in my care · Female · 2022-06-24

Timeline

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

2021-01-16
Dose 1 — Moderna
2021-02-13
Dose 2 — Moderna
2021-02-20
Registered in v-safe
2021-02-20
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-27
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-06
Survey response — day 21, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Frequent headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-10-25
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Swollen armpit lymph nodes (rt armpit only)

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: Swollen lymph nodes

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-27
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-12
Dose 4 — Pfizer-BioNTech
2022-09-12
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-09-16
Survey response — days 1–6 daily, dose 4
MedDRA: Axillary pain — Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Armpit ache

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2022-09-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-19
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-26
Survey response — day 14, dose 4
MedDRA: Fatigue — Feeling: Fair · Be unable to work or attend school

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-10-03
Survey response — day 21, dose 4
MedDRA: Cough, Headache, Nasopharyngitis, Respiratory tract congestion, Rhinorrhoea, Sneezing — Feeling: Fair

Free text: Mild cold (runny nose, congestion, dry cough, sneezing, headache)

MedDRA releases: 2024-11 · check-in free text available
2022-10-10
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-10-17
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-24
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-12
Survey response — 3 months, dose 4
MedDRA: Cough, Fatigue, Headache, Malaise, Nausea, Paranasal sinus discomfort, Pyrexia, Respiratory tract congestion, Sinusitis, Tympanic membrane perforation, Upper respiratory tract infection, Viral infection — Feeling: Fair · 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: Some kind of URI/virus/sinus infection. For about two weeks I've been sick (cough, congestion, few days of low grade fever & nausea, fatigue, headache, etc.). The sinus pressure was so bad last weekend that it ruptured my eardrum

MedDRA releases: 2024-11 · check-in free text available
2022-12-12
Report sent to call center — 3 months, dose 4
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)
2022-12-13
Call 1 — Left Voicemail
2022-12-16
Call 2 — Left Voicemail
2022-12-16
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-13
Survey response — 6 months, dose 4
MedDRA: Pregnancy — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-16	Moderna
2	2021-02-13	Moderna
3	2021-10-25	Pfizer-BioNTech	Flu
4	2022-09-12	Pfizer-BioNTech	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — day 21, dose 2

2021-03-06

Symptoms: Frequent headaches

Release 10 — days 1–6 daily, dose 3

2021-10-27

Systemic reaction (other): Swollen armpit lymph nodes (rt armpit only)

2021-10-28

Systemic reaction (other): Swollen lymph nodes

Release 12 — days 1–6 daily, dose 4

2022-09-16

Systemic reaction (other): Armpit ache

Release 12 — day 14, dose 4

2022-09-26

Symptoms: Fatigue

Release 12 — day 21, dose 4

2022-10-03

Symptoms: Mild cold (runny nose, congestion, dry cough, sneezing, headache)

Release 12 — 3 months, dose 4

2022-12-12

Symptoms: Some kind of URI/virus/sinus infection. For about two weeks I've been sick (cough, congestion, few days of low grade fever & nausea, fatigue, headache, etc.). The sinus pressure was so bad last weekend that it ruptured my eardrum

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	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Malaise	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Pregnancy	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinusitis	·	·	✓
SD	Sneezing	·	·	✓
SD	Tympanic membrane perforation	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Viral infection	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓

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