M3Q-25588-09126

4 vaccinations 7 coded responses 37 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 956 / CA
Registered: 2021-03-22

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

Timeline

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

2021-03-22
Registered in v-safe
2021-03-22
Dose 1 — Pfizer-BioNTech
2021-03-22
Survey response — day 0, dose 1
MedDRA: Rhinorrhoea — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Fatigue or tiredness

Free text: sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Anxiety — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Severe anxiety

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-12
Dose 2 — Pfizer-BioNTech
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-08
Dose 3 — Moderna
2022-04-12
Survey response — 12 months, dose 2
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative, Sinusitis — Feeling: Poor · Be unable to do your normal daily activities

Free text: Currently (today) seem to have a head cold or possibly sinus infection. Covid test was negative. Have otherwise been healthy.

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-27
Dose 4 — Moderna
2022-09-27
Health check-in — day 0, dose 4
Feeling: Fair · None

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-09-29
Survey response — days 1–6 daily, dose 4
MedDRA: Abortion spontaneous — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: Miscarriage

MedDRA releases: 2024-11 · check-in free text available
2022-10-01
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Nausea

Adult check-in
2022-10-02
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-10-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-04
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-11
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-10-18
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-25
Survey response — day 28, dose 4
MedDRA: COVID-19 — 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 · Telehealth, virtual health, or email health consultation

Free text: Covid

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Report sent to call center — day 28, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-01
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-11-08
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-12-27
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-03-28
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Pfizer-BioNTech
2	2021-04-12	Pfizer-BioNTech
3	2021-11-08	Moderna	No
4	2022-09-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-10-25	Successful 2022-10-26	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6 — day 0, dose 1

2021-03-22

Systemic reaction (other): Runny nose

Release 6 — days 1–6 daily, dose 1

2021-03-23

Systemic reaction (other): sore throat

2021-03-25

Systemic reaction (other): Severe anxiety

Release 7 — days 1–6 daily, dose 2

2021-04-16

Systemic reaction (other): Sore throat

Release 11 — 12 months, dose 2

2022-04-12

Symptoms: Currently (today) seem to have a head cold or possibly sinus infection. Covid test was negative. Have otherwise been healthy.

Release 12 — days 1–6 daily, dose 4

2022-09-29

Systemic reaction (other): Miscarriage

Release 12 — day 28, dose 4

2022-10-25

Symptoms: Covid

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	COVID-19	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Abortion spontaneous	·	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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