YZN-21709-44515

4 vaccinations 5 coded responses 43 check-ins 4 free-text entries 4 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 605 / IL
Registered: 2021-04-06

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

Registered dependents

XKR-11485-02356 Child or adolescent in my care · Female · 2022-07-13

X8R-26974-03598 Child or adolescent in my care · Male · 2022-07-13

Timeline

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

2021-03-15
Dose 1 — Pfizer-BioNTech
2021-04-06
Registered in v-safe
2021-04-06
Dose 2 — Pfizer-BioNTech
2021-04-06
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Chills, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, 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
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-05
Dose 3 — Pfizer-BioNTech
2021-10-05
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-05
Survey response — day 0, dose 3
MedDRA: Dizziness — Feeling: Fair · Headache

Free text: Light headed

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-10-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2021-10-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-14
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-28
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-10
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-04
Survey response — 3 months, dose 3
MedDRA: Amniotic fluid volume decreased, Chills, Influenza virus test negative, Pyrexia, SARS-CoV-2 test negative — Feeling: Fair · 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: Fever and chills for < day; covid and flu negative Low amniotic fluid

MedDRA releases: 2024-11 · check-in free text available
2022-01-04
Report sent to call center — 3 months, dose 3
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)
2022-01-06
Call 1 — Left Voicemail
2022-04-05
Survey response — 6 months, dose 3
MedDRA: Anaemia, Caesarean section, Delivery, Wound infection — 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 · Outpatient clinic or urgent care clinic visit

Free text: Had baby 1/25/22. Still have anemia and csection wound infection twice

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Report sent to call center — 6 months, dose 3
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)
2022-04-12
Call 2 — Left Voicemail
2022-10-05
Survey response — 12 months, dose 3
MedDRA: COVID-19, Malaise, Nasopharyngitis — 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

Free text: I've had Covid and two colds. Currently sick with cold number 2

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Report sent to call center — 12 months, dose 3
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)
2022-10-06
Call 3 — Left Voicemail
2022-10-06
Call 3 — Left Voicemail
2022-10-06
Call 2 — Left Voicemail
2023-01-31
Dose 4 — Moderna
2023-01-31
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · None

Adult check-in
2023-02-01
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2023-02-02
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2023-02-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2023-02-04
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2023-02-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2023-02-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2023-02-15
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2023-02-23
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2023-03-02
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-03-07
Survey response — day 35, dose 4
MedDRA: Diarrhoea, Dizziness, Fatigue, Headache, Pyrexia, Vomiting, Weight decreased — 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 · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-03-07
Report sent to call center — day 35, 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)
2023-03-08
Call 2 — Left Voicemail
2023-03-08
Call 1 — Left Voicemail
2023-03-08
Call 1 — Left Voicemail
2023-03-08
Call 1 — Left Voicemail
2023-03-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-05-02
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Pfizer-BioNTech
2	2021-04-06	Pfizer-BioNTech
3	2021-10-05	Pfizer-BioNTech	No
4	2023-01-31	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-04	Unsuccessful
2022-04-05	Unsuccessful
2022-10-05	Unsuccessful
2023-03-07	Unsuccessful

Free text

Release 10 — day 0, dose 3

2021-10-05

Systemic reaction (other): Light headed

Release 10 — 3 months, dose 3

2022-01-04

Symptoms: Fever and chills for < day; covid and flu negative Low amniotic fluid

Release 11 — 6 months, dose 3

2022-04-05

Symptoms: Had baby 1/25/22. Still have anemia and csection wound infection twice

Release 12 — 12 months, dose 3

2022-10-05

Symptoms: I've had Covid and two colds. Currently sick with cold number 2

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	Amniotic fluid volume decreased	·	·	✓
SD	Anaemia	·	·	✓
SD	Caesarean section	·	·	✓
SD	Chills	·	·	✓
SD	COVID-19	·	·	✓
SD	Delivery	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Influenza virus test negative	·	·	✓
SD	Malaise	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vomiting	·	·	✓
SD	Weight decreased	·	·	✓
SD	Wound infection	·	·	✓
SRO	Dizziness	·	·	✓

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