B9L-11568-00765
4 vaccinations
4 coded responses
24 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 029 / RI
- Registered
- 2021-11-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
7AY-18295-45883
Child or adolescent in my care · Male · 2021-11-14
Timeline
-
2021-03-10
Dose 1 — Pfizer-BioNTech
-
2021-03-31
Dose 2 — Pfizer-BioNTech
-
2021-11-14
Registered in v-safe
-
2021-12-10
Dose 3 — Moderna
-
2021-12-10
Health check-in — day 0, dose 3Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
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2021-12-11
Survey response — days 1–6 daily, dose 3MedDRA: Insomnia, Thirst — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Increased thirst, trouble sleepingMedDRA releases: 2024-11 · check-in free text available
-
2021-12-12
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-12-14
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-12-15
- 2021-12-16
- 2021-12-17
- 2021-12-24
- 2021-12-31
- 2022-01-07
- 2022-01-14
- 2022-01-21
- 2022-03-11
-
2022-06-10
Survey response — 6 months, dose 3MedDRA: Alopecia areata, Pregnancy — Feeling: GoodFree text: Alopecia areata- could also have resulted from immune system during pregnancyMedDRA releases: 2024-11 · check-in free text available
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2022-09-24
Dose 4 — Moderna
- 2022-09-29
- 2022-09-30
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2022-10-01
Health check-in — day 7, dose 4Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-10-08
Survey response — day 14, dose 4MedDRA: Fatigue, Oropharyngeal pain, Rhinorrhoea — Feeling: FairFree text: Sore throat, tiredness, runny noseMedDRA releases: 2024-11 · check-in free text available
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2022-10-15
Survey response — day 21, dose 4MedDRA: Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
- 2022-10-24
- 2022-10-29
- 2022-11-07
- 2022-12-24
- 2023-03-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Pfizer-BioNTech | No |
| 2 | 2021-03-31 | Pfizer-BioNTech | No |
| 3 | 2021-12-10 | Moderna | No |
| 4 | 2022-09-24 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Increased thirst, trouble sleeping
Release 12 — 6 months, dose 3
Symptoms: Alopecia areata- could also have resulted from immune system during pregnancy
Release 12 — day 14, dose 4
Symptoms: Sore throat, tiredness, runny nose
Release 12 — day 21, dose 4
Symptoms: Sore throat
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 | Alopecia areata | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Insomnia | · | · | ✓ |
| SRO | Thirst | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release