VH3-18979-15693

5 vaccinations 7 coded responses 39 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 945 / CA
Registered: 2021-03-20

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

Registered dependents

AQC-24120-50635 Child or adolescent in my care · Female · 2022-06-25

HGT-20193-62058 Child or adolescent in my care · Female · 2023-03-21

Timeline

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

2021-03-19
Dose 1 — Pfizer-BioNTech
2021-03-20
Registered in v-safe
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-04-09
Dose 2 — Pfizer-BioNTech
2021-04-09
Health check-in — 0 day, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

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

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-16
Health check-in — 7 day, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-23
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-04-30
Survey response — 21 day, dose 2
MedDRA: Unevaluable event — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-07
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-07-09
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-10-08
Survey response — 6 month, dose 2
MedDRA: Pregnancy — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available
2021-11-30
Dose 3 — Pfizer-BioNTech
2022-04-09
Survey response — 12 month, dose 2
MedDRA: Pregnancy, SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-04-28
Dose 4 — Moderna
2022-07-28
Health check-in — 3 month, dose 4
Feeling: Good

Adult check-in
2022-10-12
Dose 5 — Moderna
Co-administered: Flu
2022-10-13
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-14
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-10-15
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2022-10-16
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Adult check-in
2022-10-17
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-18
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-21
Health check-in — 7 day, dose 5
Feeling: Good · None

Adult check-in
2022-10-26
Health check-in — 14 day, dose 5
Feeling: Good

Adult check-in
2022-11-02
Health check-in — 21 day, dose 5
Feeling: Good

Adult check-in
2022-11-09
Health check-in — 28 day, dose 5
Feeling: Good

Adult check-in
2022-11-16
Survey response — 35 day, dose 5
MedDRA: Cough, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2022-11-16
Report sent to call center — 35 day, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-11-17
Call 2 — Left Voicemail
2022-11-23
Survey response — 42 day, dose 5
MedDRA: Influenza, Nasopharyngitis — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2023-01-11
Survey response — 3 month, dose 5
MedDRA: Influenza, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2023-01-11
Report sent to call center — 3 month, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-01-12
Call 1 — Left Voicemail
2023-01-12
Call 1 — Left Voicemail
2023-04-12
Health check-in — 6 month, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Pfizer-BioNTech
2	2021-04-09	Pfizer-BioNTech
3	2021-11-30	Pfizer-BioNTech	No
4	2022-04-28	Moderna	No
5	2022-10-12	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-11-16	Unsuccessful
2023-01-11	Unsuccessful

Free text

Release 7

Systemic reaction (other): Dizziness

Release 8

Symptoms: My husband and I have been trying to conceive and I believe I had a chemical pregnancy. Conception was within days of receiving the second vaccination. Our fertility doctor had confirmed two follicles for this cycle and I was a week late.

Release 10

Symptoms: Pregnant

Release 11

Symptoms: 1. 31.5 weeks pregnant 2. Tested positive for COVID on January 11, 2022

Release 12

Symptoms: Sinus and cough

Symptoms: Cold/flu

Free-text releases are not linked to a specific 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	Cough	·	·	✓
SD	Influenza	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pregnancy	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Dizziness	✓	✓	✓

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