TH6-19012-13790

5 vaccinations 20 coded responses 66 check-ins 20 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 223 / VA
Registered: 2021-03-13

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

Registered dependents

4SP-79745-13609 Child or adolescent in my care · Male · 2022-06-24

3SU-14161-99185 Child or adolescent in my care · Female · 2022-06-24

P2B-18794-62173 Child or adolescent in my care · Female · 2022-11-06

Timeline

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

2021-03-13
Registered in v-safe
2021-03-13
Dose 1 — Pfizer-BioNTech
2021-03-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Increased appetite — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Vomiting · Be unable to work, Be unable to do your normal daily activities

Free text: Brain fog, increased appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness · Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Headache · Be unable to work

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Urinary retention — Feeling: Poor · Site: Redness · Fever · Headache, Abdominal pain

Free text: Urinary retention, possible uti

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Headache, Nausea, Abdominal pain

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — day 7, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-03-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-03
Dose 2 — Pfizer-BioNTech
2021-04-03
Survey response — day 0, dose 2
MedDRA: Feeling abnormal — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Brain fog

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

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal — Feeling: Poor · Site: Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Brain fog, lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain — Feeling: Fair · Site: Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Ear ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Fluid retention — Feeling: Good · Fatigue or tiredness

Free text: Water retention

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Fluid retention — Feeling: Poor · Fever · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Retaining water

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 7, dose 2
Feeling: Fair · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-08
Survey response — day 35, dose 2
MedDRA: Depression — Feeling: Poor · Be unable to do your normal daily activities

Free text: Mental health is very bad. Depression.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — day 42, dose 2
MedDRA: Arthralgia — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Joint pain in shoulder

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-03
Survey response — 3 months, dose 2
MedDRA: Pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I've been very achey

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-02
Survey response — 6 months, dose 2
MedDRA: Office visit, Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Pregnancy · Healthcare visit (other): Regular obgyn

MedDRA releases: 2024-11 · check-in free text available
2021-10-02
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-06
Dose 3 — Pfizer-BioNTech
2021-10-06
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-10-06
Call 1 — Left Voicemail
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-10-10
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-11
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-10-14
Health check-in — day 7, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-10-22
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-27
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-03
Health check-in — day 28, dose 3
Feeling: Good

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

Adult check-in
2021-11-17
Survey response — day 42, dose 3
MedDRA: Nasopharyngitis — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I have a cold.

MedDRA releases: 2024-11 · check-in free text available
2022-01-05
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-02-24
Dose 4 — Moderna
2022-02-24
Health check-in — day 0, dose 4
Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-02-25
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-02-26
Survey response — days 1–6 daily, dose 4
MedDRA: Chest discomfort, Oropharyngeal pain, Wheezing — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat, tight chest, mild wheezing

MedDRA releases: 2024-11 · check-in free text available
2022-02-27
Survey response — days 1–6 daily, dose 4
MedDRA: Chest discomfort, Oropharyngeal pain, Rhinorrhoea — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat, tight chest, runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-02-28
Survey response — days 1–6 daily, dose 4
MedDRA: Rhinorrhoea — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-03-02
Survey response — days 1–6 daily, dose 4
MedDRA: Cough — Feeling: Poor · Fatigue or tiredness

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2022-03-03
Health check-in — day 7, dose 4
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-03-10
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-03-17
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-03-25
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-03-31
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-04-07
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-05-26
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-08-25
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-09-25
Dose 5 — Moderna
Co-administered: Flu
2022-09-26
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school

Adult check-in
2022-09-27
Survey response — days 1–6 daily, dose 5
MedDRA: Chest discomfort — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Chest tightness

MedDRA releases: 2024-11 · check-in free text available
2022-09-28
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-09-29
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-09-30
Survey response — days 1–6 daily, dose 5
MedDRA: Bronchitis — Feeling: Poor · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Bronchitis

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Report sent to call center — days 1–6 daily, dose 5
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-01
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fever · Chills, Fatigue or tiredness, Nausea

Adult check-in
2022-10-02
Health check-in — day 7, dose 5
Feeling: Poor · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-03
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-11
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-17
Survey response — day 21, dose 5
MedDRA: Gastroenteritis viral, Gastrointestinal disorder — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Stomach bug and digestive issues.

MedDRA releases: 2024-11 · check-in free text available
2022-10-23
Survey response — day 28, dose 5
MedDRA: Asthma, Respiratory disorder — Feeling: Fair

Free text: Breathing problems/asthma

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-11-06
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-25
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-28
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Pfizer-BioNTech
2	2021-04-03	Pfizer-BioNTech
3	2021-10-06	Pfizer-BioNTech	No
4	2022-02-24	Moderna	No
5	2022-09-25	Moderna	Flu

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-14

Systemic reaction (other): Brain fog, increased appetite

2021-03-17

Systemic reaction (other): Urinary retention, possible uti

Release 6 — day 0, dose 2

2021-04-03

Systemic reaction (other): Brain fog

Release 6 — days 1–6 daily, dose 2

2021-04-05

Systemic reaction (other): Brain fog, lightheaded

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Ear ache

2021-04-08

Systemic reaction (other): Water retention

2021-04-09

Systemic reaction (other): Retaining water

Release 8 — day 35, dose 2

2021-05-08

Symptoms: Mental health is very bad. Depression.

Release 8 — day 42, dose 2

2021-05-15

Symptoms: Joint pain in shoulder

Release 9 — 3 months, dose 2

2021-07-03

Symptoms: I've been very achey

Release 9 — 6 months, dose 2

2021-10-02

Symptoms: Pregnancy

Healthcare visit (other): Regular obgyn

Release 10 — day 42, dose 3

2021-11-17

Symptoms: I have a cold.

Release 11 — days 1–6 daily, dose 4

2022-02-26

Systemic reaction (other): Sore throat, tight chest, mild wheezing

2022-02-27

Systemic reaction (other): Sore throat, tight chest, runny nose

2022-02-28

Systemic reaction (other): Runny nose

2022-03-02

Systemic reaction (other): Cough

Release 12 — days 1–6 daily, dose 5

2022-09-27

Systemic reaction (other): Chest tightness

2022-09-30

Systemic reaction (other): Bronchitis

Release 12 — day 21, dose 5

2022-10-17

Symptoms: Stomach bug and digestive issues.

Release 12 — day 28, dose 5

2022-10-23

Symptoms: Breathing problems/asthma

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
HCVO	Office visit	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Asthma	·	·	✓
SD	Depression	✓	✓	✓
SD	Gastroenteritis viral	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Respiratory disorder	·	·	✓
SRO	Bronchitis	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Cough	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Fluid retention	✓	✓	✓
SRO	Increased appetite	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Urinary retention	✓	✓	✓
SRO	Wheezing	·	·	✓

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