Z93-22698-33950

4 vaccinations 10 coded responses 38 check-ins 10 free-text entries 0 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 801 / CO
Registered: 2021-03-13

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

Registered dependents

9KG-89864-87593 Child or adolescent in my care · Male · 2022-06-22

57R-16456-50332 Child or adolescent in my care · Male · 2022-06-22

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-12
Dose 1 — Pfizer-BioNTech
2021-03-13
Registered in v-safe
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Pfizer-BioNTech
2021-04-02
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Breast feeding, Decreased appetite, Epistaxis — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Breastfeeding. nosebleed. Loss of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Suppressed lactation — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Breastfeeding supply drop

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Breast feeding, Suppressed lactation — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Breastmilk supply drop

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-09
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Survey response — day 21, dose 2
MedDRA: Diarrhoea — Feeling: Good

Free text: Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 35, dose 2
MedDRA: Abnormal dreams — Feeling: Good

Free text: Frequent vivid dreams

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-01
Survey response — 6 months, dose 2
MedDRA: Antinuclear antibody positive, Arthralgia — Feeling: Good · Be unable to do your normal daily activities

Free text: Joint pan and positive ANA (antinuclear antibody test) bloodwork with referral to Rheumatologist

MedDRA releases: 2024-11 · check-in free text available
2021-11-10
Dose 3 — Moderna
2022-04-02
Survey response — 12 months, dose 2
MedDRA: Antinuclear antibody positive, Arthralgia, Fatigue, Muscular weakness, Myalgia — Feeling: Good · Be unable to do your normal daily activities

Free text: Joint pain, fatigue, muscle weakness/soreness leading to bloodwork which revealed Positive ANA test.

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-10
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2022-11-17
Dose 4 — Moderna
2022-11-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-11-21
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-11-22
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-11-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-11-24
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-12-01
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-12-08
Survey response — day 21, dose 4
MedDRA: Chills, Diarrhoea, Fatigue, Pain, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Congestion. Body aches. Fatigue. Diarrhea. Chills.

MedDRA releases: 2024-11 · check-in free text available
2022-12-15
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-22
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-31
Survey response — day 42, dose 4
MedDRA: Arthralgia, Chills, Pain, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fever, chills, body aches, joint pain

MedDRA releases: 2024-11 · check-in free text available
2023-05-20
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Pfizer-BioNTech
2	2021-04-02	Pfizer-BioNTech
3	2021-11-10	Moderna	No
4	2022-11-17	Moderna	No

Free text

Release 6 — days 1–6 daily, dose 2

2021-04-03

Systemic reaction (other): Breastfeeding. nosebleed. Loss of appetite

2021-04-04

Systemic reaction (other): Breastfeeding supply drop

2021-04-05

Systemic reaction (other): Breastmilk supply drop

Release 7 — day 21, dose 2

2021-04-23

Symptoms: Diarrhea

Release 8 — day 35, dose 2

2021-05-07

Symptoms: Frequent vivid dreams

Release 9 — 6 months, dose 2

2021-10-01

Symptoms: Joint pan and positive ANA (antinuclear antibody test) bloodwork with referral to Rheumatologist

Release 11 — 12 months, dose 2

2022-04-02

Symptoms: Joint pain, fatigue, muscle weakness/soreness leading to bloodwork which revealed Positive ANA test.

Release 12 — days 1–6 daily, dose 4

2022-11-22

Systemic reaction (other): Sore throat

Release 12 — day 21, dose 4

2022-12-08

Symptoms: Congestion. Body aches. Fatigue. Diarrhea. Chills.

Release 12 — day 42, dose 4

2022-12-31

Symptoms: Fever, chills, body aches, joint pain

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	Abnormal dreams	✓	✓	✓
SD	Antinuclear antibody positive	·	·	✓
SD	Arthralgia	·	·	✓
SD	Chills	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Muscular weakness	·	·	✓
SD	Myalgia	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Breast feeding	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Epistaxis	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Suppressed lactation	✓	✓	✓

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