VRC-11721-41867
4 vaccinations
8 coded responses
45 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 631 / MO
- Registered
- 2021-07-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
NCP-73601-02440
Child or adolescent in my care · Male · 2022-06-29
Timeline
-
2021-07-28
Registered in v-safe
-
2021-07-28
Dose 1 — Pfizer-BioNTech
- 2021-07-28
-
2021-07-29
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tiredness, NauseaAdult check-in
- 2021-07-30
- 2021-07-31
- 2021-08-01
- 2021-08-02
- 2021-08-03
- 2021-08-04
- 2021-08-13
- 2021-08-20
-
2021-08-21
Dose 2 — Pfizer-BioNTech
- 2021-08-25
- 2021-08-26
- 2021-08-27
- 2021-08-28
- 2021-09-04
- 2021-09-11
- 2021-09-18
- 2021-09-25
- 2021-10-02
- 2021-11-21
-
2022-01-14
Dose 3 — Moderna
-
2022-01-15
Survey response — days 1–6 daily, dose 3MedDRA: Decreased appetite — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Lack of appetiteMedDRA releases: 2024-11 · check-in free text available
-
2022-01-16
Survey response — days 1–6 daily, dose 3MedDRA: Hot flush, Hyperhidrosis — Feeling: Fair · Site: Pain, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal painFree text: Hot flashes/sweatingMedDRA releases: 2024-11 · check-in free text available
-
2022-01-17
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Swollen lymph nodes in injection armMedDRA releases: 2024-11 · check-in free text available
-
2022-01-18
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Redness, Itching · Joint pains, Muscle or body achesFree text: Swollen lymph nodes in injection armMedDRA releases: 2024-11 · check-in free text available
-
2022-01-19
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain · Joint pains, Muscle or body achesFree text: Swollen lymph nodes in injection armMedDRA releases: 2024-11 · check-in free text available
-
2022-01-20
Health check-in — days 1–6 daily, dose 3Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
- 2022-01-21
-
2022-01-31
Survey response — day 14, dose 3MedDRA: Nasopharyngitis, Respiratory tract infection viral — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Cold (respiratory virus)MedDRA releases: 2024-11 · check-in free text available
- 2022-02-13
- 2022-02-20
- 2022-02-25
-
2022-04-17
Survey response — 3 months, dose 3MedDRA: Herpes simplex — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Recurrent HSV outbreaksMedDRA releases: 2024-11 · check-in free text available
-
2022-04-17
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-20
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-07-15
-
2022-08-12
Dose 4 — Moderna
-
2022-08-12
Health check-in — day 0, dose 4Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2022-08-13
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2022-08-14
Survey response — days 1–6 daily, dose 4MedDRA: Night sweats — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Night sweatsMedDRA releases: 2024-11 · check-in free text available
-
2022-08-15
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2022-08-17
- 2022-08-19
- 2022-08-28
- 2022-09-04
- 2022-09-09
- 2022-09-18
- 2022-11-13
- 2023-02-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-07-28 | Pfizer-BioNTech | No |
| 2 | 2021-08-21 | Pfizer-BioNTech | No |
| 3 | 2022-01-14 | Moderna | No |
| 4 | 2022-08-12 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-17 | Successful 2022-04-20 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Lack of appetite
Systemic reaction (other): Hot flashes/sweating
Systemic reaction (other): Swollen lymph nodes in injection arm
Systemic reaction (other): Swollen lymph nodes in injection arm
Systemic reaction (other): Swollen lymph nodes in injection arm
Release 11 — day 14, dose 3
Symptoms: Cold (respiratory virus)
Release 11 — 3 months, dose 3
Symptoms: Recurrent HSV outbreaks
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Night sweats
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 | Herpes simplex | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Respiratory tract infection viral | · | · | ✓ |
| SRO | Decreased appetite | · | · | ✓ |
| SRO | Hot flush | · | · | ✓ |
| SRO | Hyperhidrosis | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Night sweats | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release