LVY-14141-91045

4 vaccinations 6 coded responses 52 check-ins 6 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 086 / NJ
Registered: 2021-02-17

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

Registered dependents

WT9-16963-12158 Child or adolescent in my care · Female · 2022-07-28

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-16
Dose 1 — Pfizer-BioNTech
2021-02-17
Registered in v-safe
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-09
Dose 2 — Pfizer-BioNTech
2021-03-09
Survey response — day 0, dose 2
MedDRA: Abnormal menstrual clots, Heavy menstrual bleeding — Feeling: Good

Free text: After my first shot I had the heaviest period Ive ever hadmore blood and clotting than even post-partum.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-13
Survey response — day 35, dose 2
MedDRA: Axillary pain, Breast pain — Feeling: Good

Free text: Soreness in both sides of breasts armpit areas.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-08
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in
2021-10-02
Dose 3 — Pfizer-BioNTech
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Chills, Fatigue or tiredness, Nausea

Adult check-in
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-10-09
Health check-in — day 7, dose 3
Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-01
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-02
Survey response — 6 months, dose 3
MedDRA: Abortion spontaneous — Feeling: Good

Free text: Miscarriage

MedDRA releases: 2024-11 · check-in free text available
2022-10-02
Survey response — 12 months, dose 3
MedDRA: Pregnancy — Feeling: Good

Free text: Pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-10-19
Dose 4 — Moderna
2022-10-19
Survey response — day 0, dose 4
MedDRA: Pregnancy — Feeling: Good · Site: Pain

Free text: Pregnancy 20 weeks

MedDRA releases: 2024-11 · check-in free text available
2022-10-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-10-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-25
Survey response — days 1–6 daily, dose 4
MedDRA: Paraesthesia — Feeling: Fair

Free text: Tingling in legs

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-11-02
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-16
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-23
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-30
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-18
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-19
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-16	Pfizer-BioNTech
2	2021-03-09	Pfizer-BioNTech
3	2021-10-02	Pfizer-BioNTech	No
4	2022-10-19	Moderna	No

Free text

Release 5 — day 0, dose 2

2021-03-09

Systemic reaction (other): After my first shot I had the heaviest period Ive ever hadmore blood and clotting than even post-partum.

Release 7 — day 35, dose 2

2021-04-13

Symptoms: Soreness in both sides of breasts armpit areas.

Release 11 — 6 months, dose 3

2022-04-02

Symptoms: Miscarriage

Release 12 — 12 months, dose 3

2022-10-02

Symptoms: Pregnancy

Release 12 — day 0, dose 4

2022-10-19

Systemic reaction (other): Pregnancy 20 weeks

Release 12 — days 1–6 daily, dose 4

2022-10-25

Systemic reaction (other): Tingling in legs

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	·	·	✓
SD	Axillary pain	✓	✓	✓
SD	Breast pain	✓	✓	✓
SD	Pregnancy	·	·	✓
SRO	Abnormal menstrual clots	✓	✓	✓
SRO	Heavy menstrual bleeding	✓	✓	✓
SRO	Paraesthesia	·	·	✓
SRO	Pregnancy	·	·	✓

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