J4M-20359-25951

4 vaccinations 3 coded responses 46 check-ins 3 free-text entries 0 call cases

Sex: Female
Age at first dose: 05-11
ZIP prefix: 201 / VA
Registered: 2021-11-08

Relationship: Child or adolescent in my care
Guardian: 529-14836-28049
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-11-08
Registered in v-safe
2021-11-08
Dose 1 — Pfizer-BioNTech
2021-11-08
Health check-in — day 0, dose 1, dependent
Feeling: Fair · Site: Pain, Redness · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-09
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Decreased appetite — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Loss of appetite

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-12
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-13
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-14
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-15
Health check-in — day 7, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-22
Health check-in — day 14, dose 1, dependent
Feeling: Good

Adult check-in
2021-11-29
Dose 2 — Pfizer-BioNTech
2021-11-29
Health check-in — day 0, dose 2, dependent
Feeling: Fair · Site: Pain · None

Adult check-in
2021-11-30
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-01
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-12-02
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Injection site erythema, Injection site induration, Injection site mass — Feeling: Good · Site: Redness

Free text: Hard lump at injection site where its red

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Injection site induration, Injection site swelling — Feeling: Good · Site: Redness

Free text: Hard bump at injection site

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-06
Health check-in — day 7, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-13
Health check-in — day 14, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-20
Health check-in — day 21, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-27
Health check-in — day 28, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-03
Health check-in — day 35, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-10
Health check-in — day 42, dose 2, dependent
Feeling: Good

Adult check-in
2022-02-28
Health check-in — 3 months, dose 2, dependent
Feeling: Good

Adult check-in
2022-05-30
Health check-in — 6 months, dose 2, dependent
Feeling: Good

Adult check-in
2022-06-11
Dose 3 — Pfizer-BioNTech
2022-06-13
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2022-06-14
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2022-06-15
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Site: Redness · None

Adult check-in
2022-06-16
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-06-20
Health check-in — day 7, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-06-25
Health check-in — day 14, dose 3, dependent
Feeling: Good

Adult check-in
2022-07-02
Health check-in — day 21, dose 3, dependent
Feeling: Good

Adult check-in
2022-07-11
Health check-in — day 28, dose 3, dependent
Feeling: Good

Adult check-in
2022-07-17
Health check-in — day 35, dose 3, dependent
Feeling: Good

Adult check-in
2022-07-23
Health check-in — day 42, dose 3, dependent
Feeling: Good

Adult check-in
2022-09-10
Health check-in — 3 months, dose 3, dependent
Feeling: Good

Adult check-in
2022-12-29
Dose 4 — Pfizer-BioNTech
2022-12-31
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2023-01-01
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · Site: Redness · None

Adult check-in
2023-01-02
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · Site: Redness · None

Adult check-in
2023-01-04
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · None

Adult check-in
2023-01-05
Health check-in — day 7, dose 4, dependent
Feeling: Good · None

Adult check-in
2023-01-14
Health check-in — day 14, dose 4, dependent
Feeling: Good

Adult check-in
2023-01-19
Health check-in — day 21, dose 4, dependent
Feeling: Good

Adult check-in
2023-01-28
Health check-in — day 28, dose 4, dependent
Feeling: Good

Adult check-in
2023-02-02
Health check-in — day 35, dose 4, dependent
Feeling: Good

Adult check-in
2023-02-09
Health check-in — day 42, dose 4, dependent
Feeling: Good

Adult check-in
2023-03-30
Health check-in — 3 months, dose 4, dependent
Feeling: Good

Adult check-in
2023-06-29
Health check-in — 6 months, dose 4, dependent
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-11-08	Pfizer-BioNTech	No
2	2021-11-29	Pfizer-BioNTech	No
3	2022-06-11	Pfizer-BioNTech	No
4	2022-12-29	Pfizer-BioNTech	No

Free text

Release 10 — days 1–6 daily, dose 1, dependent

2021-11-09

Systemic reaction (other): Loss of appetite

Release 10 — days 1–6 daily, dose 2, dependent

2021-12-02

Systemic reaction (other): Hard lump at injection site where its red

2021-12-03

Systemic reaction (other): Hard bump at injection site

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
SRO	Decreased appetite	·	·	✓
SRO	Injection site erythema	·	·	✓
SRO	Injection site induration	·	·	✓
SRO	Injection site mass	·	·	✓
SRO	Injection site swelling	·	·	✓

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