XNC-94775-16900

4 vaccinations 7 coded responses 27 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 021 / MA
Registered: 2021-07-02

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

Registered dependents

JPV-29343-16494 Child or adolescent in my care · Male · 2022-07-31

C8Z-31360-14328 Child or adolescent in my care · Male · 2022-07-31

Timeline

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

2021-07-02
Registered in v-safe
2021-07-02
Dose 1 — Pfizer-BioNTech
2021-07-02
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-07-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-07-04
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Nasal congestion — Feeling: Poor · Headache, Joint pains · Be unable to do your normal daily activities

Free text: Joint pain is specifically in my jaw; also have stuffy nose - likely cold from my son we were all tested for covid the day before I got the vaccine and were negative and I had no symptoms on day of vaccine. Ive never had jaw pain with a cold before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-05
Survey response — days 1–6 daily, dose 1
MedDRA: Respiratory tract congestion — Feeling: Fair

Free text: Congestion likely from cold and not vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Survey response — days 1–6 daily, dose 1
MedDRA: Laryngitis, Nasopharyngitis — Feeling: Good

Free text: Laryngitis- related to cold that developed 24 h after vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-07-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-07-09
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-07-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-07-23
Dose 2 — Pfizer-BioNTech
2021-07-23
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-07-24
Survey response — days 1–6 daily, dose 2
MedDRA: Body temperature increased, Chills — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chills and elevated temperature yesterday but after the check in

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-07-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-07-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-07-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-07-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-07-30
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-08-08
Survey response — day 14, dose 2
MedDRA: Dizziness, Syncope — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lightheaded/ dizzy. Fainted

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-08-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-08-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-09-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-10-22
Survey response — 3 months, dose 2
MedDRA: Delivery — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Delivered healthy baby boy at 40 weeks + 6 days

MedDRA releases: 2024-11 · check-in free text available
2021-10-22
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2021-10-26
Call 1 — Left Voicemail
2022-01-05
Dose 3 — Moderna
2022-09-18
Dose 4 — Moderna
Co-administered: Flu
2022-10-08
Survey response — day 14, dose 4
MedDRA: Chills, Headache, Pain — Feeling: Fair · Be unable to work or attend school

Free text: Headache, chills, body aches

MedDRA releases: 2024-11 · check-in free text available
2022-10-09
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-16
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-12-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-02	Pfizer-BioNTech	No
2	2021-07-23	Pfizer-BioNTech	No
3	2022-01-05	Moderna	No
4	2022-09-18	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-10-22	Unsuccessful

Free text

Release 9 — days 1–6 daily, dose 1

2021-07-04

Systemic reaction (other): Joint pain is specifically in my jaw; also have stuffy nose - likely cold from my son we were all tested for covid the day before I got the vaccine and were negative and I had no symptoms on day of vaccine. Ive never had jaw pain with a cold before. cut off by CDC

2021-07-05

Systemic reaction (other): Congestion likely from cold and not vaccine

2021-07-06

Systemic reaction (other): Laryngitis- related to cold that developed 24 h after vaccine

Release 9 — days 1–6 daily, dose 2

2021-07-24

Systemic reaction (other): Chills and elevated temperature yesterday but after the check in

Release 9 — day 14, dose 2

2021-08-08

Symptoms: Lightheaded/ dizzy. Fainted

Release 10 — 3 months, dose 2

2021-10-22

Symptoms: Delivered healthy baby boy at 40 weeks + 6 days

Release 12 — day 14, dose 4

2022-10-08

Symptoms: Headache, chills, body aches

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	Chills	·	·	✓
SD	Delivery	·	·	✓
SD	Dizziness	✓	·	✓
SD	Headache	·	·	✓
SD	Pain	·	·	✓
SD	Syncope	✓	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Body temperature increased	✓	·	✓
SRO	Chills	✓	·	✓
SRO	Laryngitis	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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