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J4M-12934-16626

4 vaccinations 3 coded responses 19 check-ins 3 free-text entries 3 call cases
Sex
Female
Age at first dose
31-35
ZIP prefix
145 / NY
Registered
2021-03-30
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
XDT-10010-10124 Child or adolescent in my care · Male · 2022-06-23
DDV-28114-99199 Adult relative or friend · Male · 2022-06-23
XLV-27339-67279 Child or adolescent in my care · Male · 2022-06-23

Timeline

  1. 2021-02-26
    Dose 1 — Pfizer-BioNTech
  2. 2021-03-19
    Dose 2 — Pfizer-BioNTech
  3. 2021-03-30
    Registered in v-safe
  4. 2021-03-30
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  5. 2021-04-02
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  6. 2021-04-09
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  7. 2021-04-16
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  8. 2021-04-23
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  9. 2021-04-30
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-06-18
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-09-17
    Survey response — 6 months, dose 2
    MedDRA: Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    Free text: Pregnancy
    MedDRA releases: 2024-11 · check-in free text available
  12. 2021-09-17
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-09-20
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  14. 2021-10-18
    Dose 3 — Pfizer-BioNTech
  15. 2022-03-19
    Survey response — 12 months, dose 2
    MedDRA: Caesarean section, Hospitalisation — 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 · Hospitalization
    Free text: Symptoms: Cesarean section for delivery of second child on 3/17/22 · Healthcare visit (other): Cesarean section in hospital
    MedDRA releases: 2024-11 · check-in free text available
  16. 2022-03-19
    Report sent to call center — 12 months, dose 2
    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)
  17. 2022-03-22
  18. 2022-04-24
    Survey response — 6 months, dose 3
    MedDRA: Asthma, Cough — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Asthma symptoms & coughing - need inhaler in Spring 2022
    MedDRA releases: 2024-11 · check-in free text available
  19. 2022-04-24
    Report sent to call center — 6 months, dose 3
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  20. 2022-04-25
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  21. 2022-09-14
    Dose 4 — Moderna
    Co-administered: Flu
  22. 2022-09-20
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  23. 2022-09-21
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  24. 2022-09-28
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  25. 2022-10-05
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  26. 2022-10-12
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  27. 2022-10-21
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  28. 2022-10-28
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  29. 2022-12-14
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  30. 2023-03-17
    Health check-in — 6 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-26Pfizer-BioNTech
22021-03-19Pfizer-BioNTech
32021-10-18Pfizer-BioNTech No
42022-09-14Moderna Flu

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 9 — 6 months, dose 2

2021-09-17

Symptoms: Pregnancy

Release 11 — 12 months, dose 2

2022-03-19

Symptoms: Cesarean section for delivery of second child on 3/17/22
Healthcare visit (other): Cesarean section in hospital

Release 11 — 6 months, dose 3

2022-04-24

Symptoms: Asthma symptoms & coughing - need inhaler in Spring 2022

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

FieldPreferred term2021-092023-042024-11
HCVOCaesarean section · · ✓
HCVOHospitalisation · · ✓
SDAsthma · · ✓
SDCaesarean section · · ✓
SDCough · · ✓
SDPregnancy · · ✓

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