E86-27251-86369

4 vaccinations 11 coded responses 46 check-ins 11 free-text entries 5 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 800 / CO
Registered: 2020-12-20

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

Registered dependents

RBD-31995-12456 Child or adolescent in my care · Male · 2022-07-01

Z2M-31999-10899 Child or adolescent in my care · Female · 2022-07-10

Timeline

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

2020-12-18
Dose 1 — Pfizer-BioNTech
2020-12-20
Registered in v-safe
2020-12-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2020-12-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-08
Dose 2 — Pfizer-BioNTech
2021-01-08
Survey response — day 0, dose 2
MedDRA: Chills — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches

Free text: Shivering, chattering teeth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Hyperhidrosis, Insomnia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Rigors, sweating, insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities

1 call case(s)
2021-01-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-10
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities

1 call case(s)
2021-01-11
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Swelling — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Swelling at axillary and anticubital lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-12
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lymphadenopathy in axilla and antecubital fossa

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities

1 call case(s)
2021-01-13
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain

Free text: Lymphadenopathy (axilla, antecubital)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — day 7, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Lymphadenopathy (axilla)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-01-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-02-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-08-31
Dose 3 — Pfizer-BioNTech
2021-08-31
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-09-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-09-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-09-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-09-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-09-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache · Be unable to do your normal daily activities

Adult check-in
2021-09-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-09-07
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-09-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-09-21
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-09-28
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-08
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-12
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-01
Survey response — 6 months, dose 3
MedDRA: Delivery — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Gave birth

MedDRA releases: 2024-11 · check-in free text available
2022-03-01
Report sent to call center — 6 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

Hospitalization · 1 call case(s)
2022-03-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-08-31
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2022-09-10
Dose 4 — Moderna
2022-09-11
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-09-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-17
Health check-in — day 7, dose 4
Feeling: Fair · None

Adult check-in
2022-09-24
Survey response — day 14, dose 4
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school

Free text: Cold - COVID negative

MedDRA releases: 2024-11 · check-in free text available
2022-10-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-08
Survey response — day 28, dose 4
MedDRA: Gastroenteritis viral — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Viral gastroenteritis - unrelated to vaccine; but seriously, the CDC needs to look into how viral illnesses are DESTROYING families right now after state COVID restrictions were lifted

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Survey response — day 35, dose 4
MedDRA: SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Fair · Be unable to do your normal daily activities

Free text: Ongoing URI due to school aged child and no mask requirements; COVID negative

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Survey response — day 42, dose 4
MedDRA: Gastroenteritis viral, SARS-CoV-2 test negative — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Another episode of viral gastroenteritis, COVID negative

MedDRA releases: 2024-11 · check-in free text available
2022-12-10
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-11
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-18	Pfizer-BioNTech
2	2021-01-08	Pfizer-BioNTech
3	2021-08-31	Pfizer-BioNTech	No
4	2022-09-10	Moderna	No

Call center

5 call center cases

1 successful · 4 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — day 0, dose 2

2021-01-08

Systemic reaction (other): Shivering, chattering teeth

Release 1 — days 1–6 daily, dose 2

2021-01-09

Systemic reaction (other): Rigors, sweating, insomnia

2021-01-11

Systemic reaction (other): Swelling at axillary and anticubital lymph nodes

2021-01-12

Systemic reaction (other): Lymphadenopathy in axilla and antecubital fossa

2021-01-13

Systemic reaction (other): Lymphadenopathy (axilla, antecubital)

Release 2 — day 7, dose 2

2021-01-15

Systemic reaction (other): Lymphadenopathy (axilla)

Release 11 — 6 months, dose 3

2022-03-01

Symptoms: Gave birth

Release 12 — day 14, dose 4

2022-09-24

Symptoms: Cold - COVID negative

Release 12 — day 28, dose 4

2022-10-08

Symptoms: Viral gastroenteritis - unrelated to vaccine; but seriously, the CDC needs to look into how viral illnesses are DESTROYING families right now after state COVID restrictions were lifted

Release 12 — day 35, dose 4

2022-10-15

Symptoms: Ongoing URI due to school aged child and no mask requirements; COVID negative

Release 12 — day 42, dose 4

2022-10-22

Symptoms: Another episode of viral gastroenteritis, COVID negative

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	Delivery	·	·	✓
SD	Gastroenteritis viral	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oedema peripheral	○	○	○
SRO	Swelling	✓	✓	✓

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