AW6-95046-30979
4 vaccinations
2 coded responses
41 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 941 / CA
- Registered
- 2021-04-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
2N4-18058-80405
Child or adolescent in my care · Female · 2022-06-21
Timeline
-
2021-04-10
Dose 1 — Pfizer-BioNTech
-
2021-04-13
Registered in v-safe
-
2021-04-13
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus — Feeling: Fair · Headache, Fatigue or tirednessFree text: General itchingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-19
- 2021-04-24
-
2021-05-01
Dose 2 — Pfizer-BioNTech
- 2021-05-01
-
2021-05-02
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal painAdult check-in
- 2021-05-04
- 2021-05-05
- 2021-05-06
- 2021-05-07
- 2021-05-08
- 2021-05-16
- 2021-05-22
- 2021-05-29
- 2021-06-07
- 2021-06-12
- 2021-07-31
- 2021-10-30
-
2021-11-05
Dose 3 — Pfizer-BioNTech
-
2021-11-08
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Fatigue or tiredness, NauseaAdult check-in
-
2021-11-09
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fatigue or tiredness, NauseaAdult check-in
-
2021-11-10
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fatigue or tiredness, NauseaAdult check-in
-
2021-11-11
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-11-12
- 2021-11-19
- 2021-11-26
-
2021-12-03
Survey response — day 28, dose 3MedDRA: Abortion spontaneous — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Pregnancy lossMedDRA releases: 2024-11 · check-in free text available
-
2021-12-03
Report sent to call center — day 28, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-12-07
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-12-10
- 2021-12-17
- 2022-02-04
- 2022-05-06
-
2022-09-16
Dose 4 — Moderna
- 2022-09-25
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-10-28
- 2022-12-17
- 2023-03-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-10 | Pfizer-BioNTech | |
| 2 | 2021-05-01 | Pfizer-BioNTech | |
| 3 | 2021-11-05 | Pfizer-BioNTech | No |
| 4 | 2022-09-16 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-03 | Successful 2021-12-07 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): General itching
Release 10 — day 28, dose 3
Symptoms: Pregnancy loss
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 | Abortion spontaneous | · | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release