WVV-80594-11431

4 vaccinations 8 coded responses 37 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 770 / TX
Registered: 2021-03-15

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

Registered dependents

LN4-36069-37838 Child or adolescent in my care · Male · 2022-06-25

Timeline

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

2021-03-15
Registered in v-safe
2021-03-15
Dose 1 — Pfizer-BioNTech
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Palpitations — Feeling: Good · Diarrhea

Free text: Racing heart

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-29
Survey response — day 14, dose 1
MedDRA: Headache — Feeling: Good

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Dose 2 — Pfizer-BioNTech
2021-04-05
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Abdominal pain

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Muscle or body aches

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-17
Survey response — day 42, dose 2
MedDRA: Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Got a cold from my son

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-20
Dose 3 — Pfizer-BioNTech
2021-11-07
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-10
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Survey response — day 28, dose 3
MedDRA: Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: High AFP identified, no structural abnormalities of fetus detected but possible placenta deficiencies suspected

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-23
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-24
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-22
Dose 4 — Moderna
2022-10-02
Health check-in — day 7, dose 4
Feeling: Good · Headache

Adult check-in
2022-10-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-13
Survey response — day 21, dose 4
MedDRA: Headache — Feeling: Good

Free text: Frequent headaches

MedDRA releases: 2024-11 · check-in free text available
2022-10-20
Survey response — day 28, dose 4
MedDRA: Influenza — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Flu A

MedDRA releases: 2024-11 · check-in free text available
2022-10-27
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-11-03
Survey response — day 42, dose 4
MedDRA: Infectious mononucleosis — 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 · Outpatient clinic or urgent care clinic visit

Free text: Diagnosed with mono

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Report sent to call center — day 42, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-04
Call 2 — Left Voicemail
2022-12-26
Health check-in — 3 months, dose 4
Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Cough, sore throat, runny nose. Ongoing mono

Adult check-in · check-in free text available
2022-12-26
Call case (no matching report) — Unsuccessful
2022-12-28
Call 3 — Left Voicemail
2022-12-28
Call 2 — Left Voicemail
2023-03-23
Survey response — 6 months, dose 4
MedDRA: COVID-19 — Feeling: Good · 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

MedDRA releases: 2024-11
2023-03-23
Report sent to call center — 6 months, 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)
2023-03-24
Call 1 — Left Voicemail
2023-03-24
Call 1 — Left Voicemail
2023-03-24
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Pfizer-BioNTech
2	2021-04-05	Pfizer-BioNTech
3	2021-10-20	Pfizer-BioNTech	No
4	2022-09-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-19	Successful 2021-11-23	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-11-03	Unsuccessful
2022-12-26	Unsuccessful
2023-03-23	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-18

Systemic reaction (other): Racing heart

Release 6 — day 14, dose 1

2021-03-29

Symptoms: Headache

Release 8 — day 42, dose 2

2021-05-17

Symptoms: Got a cold from my son

Release 10 — day 28, dose 3

2021-11-19

Symptoms: High AFP identified, no structural abnormalities of fetus detected but possible placenta deficiencies suspected

Release 12 — day 21, dose 4

2022-10-13

Symptoms: Frequent headaches

Release 12 — day 28, dose 4

2022-10-20

Symptoms: Flu A

Release 12 — day 42, dose 4

2022-11-03

Symptoms: Diagnosed with mono

Release 12 — 3 months, dose 4

2022-12-26

Symptoms: Cough, sore throat, runny nose. Ongoing mono

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	Headache	✓	✓	✓
SD	Infectious mononucleosis	·	·	✓
SD	Influenza	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Pregnancy	·	·	✓
SRO	Palpitations	✓	✓	✓

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