3J5-45702-67294
3 vaccinations
13 coded responses
32 check-ins
13 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 926 / CA
- Registered
- 2021-02-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-27
Registered in v-safe
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2021-02-27
Dose 1 — Pfizer-BioNTech
- 2021-02-27
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2021-02-28
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity — Feeling: Good · Site: PainFree text: Injected arm sore.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-02
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2021-03-03
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: Good · HeadacheFree text: Transient headache this morning. Resolved.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-13
-
2021-03-20
Dose 2 — Pfizer-BioNTech
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
-
2021-03-24
Survey response — days 1–6 daily, dose 2MedDRA: Dry eye — Feeling: GoodFree text: Dry eyesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-27
-
2021-04-03
Survey response — day 14, dose 2MedDRA: Abdominal discomfort — Feeling: FairFree text: Stomach distressMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
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2021-04-17
Survey response — day 28, dose 2MedDRA: Constipation — Feeling: FairFree text: ConstipationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-25
- 2021-05-01
- 2021-06-19
- 2021-09-18
-
2021-10-12
Dose 3 — Pfizer-BioNTechCo-administered: Flu
- 2021-10-12
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2021-10-16
Survey response — days 1–6 daily, dose 3MedDRA: Pre-existing disease — Feeling: Fair · Headache · Be unable to work or attend school, Get care from a doctor or other healthcare professional · HospitalizationFree text: Migraine/unrelated to vaccine. My migraine began the day before my booster.MedDRA releases: 2024-11 · check-in free text available
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2021-10-16
Report sent to call center — days 1–6 daily, dose 3Be unable to work or attend school · Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
- 2021-10-17
- 2021-10-19
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2021-10-21
Survey response — day 7, dose 3MedDRA: Diarrhoea — Feeling: GoodFree text: I've had diarrhea for the last 4 or 5 days.MedDRA releases: 2024-11 · check-in free text available
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2021-10-30
Survey response — day 14, dose 3MedDRA: Visual impairment — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Vision disturbancesMedDRA releases: 2024-11 · check-in free text available
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2021-10-30
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-11-02
Survey response — day 21, dose 3MedDRA: Emergency care, Migraine, Office visit, Visual impairment — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: I developed a horrible migraine that began the night of 10/12/21 (I've only had 1 other migraine-like headache in my life). After a visit to urgent care & a subsequent trip to the ER, migraine ended (on 10/16) & the extreme visual disturbance began.MedDRA releases: 2024-11 · check-in free text available
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2021-11-02
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2021-11-02
- 2021-11-03
- 2021-11-05
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2021-11-08
Call successfulCompleted over the phone
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2021-11-11
Survey response — day 28, dose 3MedDRA: Cerebrovascular accident, Headache, Magnetic resonance imaging abnormal, Visual impairment — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Visual disturbances. I'm seeing a neurologist next week. My MRI showed a small stroke. I've been extremely healthy, not one health issue before my headache began. I'm a healthy, fit, mom, wife and medical aesthetician.MedDRA releases: 2024-11 · check-in free text available
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2021-11-16
Survey response — day 35, dose 3MedDRA: Visual impairment — 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Visual disturbances. Scheduled to see a neurologist this Thursday afternoon. I'm desperate for a solution for this.MedDRA releases: 2024-11 · check-in free text available
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2021-11-16
Report sent to call center — day 35, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2021-11-17
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2021-11-24
Survey response — day 42, dose 3MedDRA: Unevaluable event — 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Symptoms: Same as before. Have an EEG scan in 10 days. · Healthcare visit (other): MRIMedDRA releases: 2024-11 · check-in free text available
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2021-11-24
Report sent to call center — day 42, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
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2022-04-14
Survey response — 6 months, dose 3MedDRA: Unevaluable event — Feeling: Fair · Be unable to work or attend schoolFree text: Same as last check-inMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-27 | Pfizer-BioNTech | |
| 2 | 2021-03-20 | Pfizer-BioNTech | |
| 3 | 2021-10-12 | Pfizer-BioNTech | Flu |
Call center
5 call center cases
3 successful · 2 unsuccessful
VAERS report filed, before or during a call: 3
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Injected arm sore.
Systemic reaction (other): Transient headache this morning. Resolved.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Dry eyes
Release 6 — day 14, dose 2
Symptoms: Stomach distress
Release 7 — day 28, dose 2
Symptoms: Constipation
Release 10 — days 1–6 daily, dose 3
Healthcare visit (other): Migraine/unrelated to vaccine. My migraine began the day before my booster.
Release 10 — day 7, dose 3
Systemic reaction (other): I've had diarrhea for the last 4 or 5 days.
Release 10 — day 14, dose 3
Symptoms: Vision disturbances
Release 10 — day 21, dose 3
Symptoms: I developed a horrible migraine that began the night of 10/12/21 (I've only had 1 other migraine-like headache in my life). After a visit to urgent care & a subsequent trip to the ER, migraine ended (on 10/16) & the extreme visual disturbance began. cut off by CDC
Release 10 — day 28, dose 3
Symptoms: Visual disturbances. I'm seeing a neurologist next week. My MRI showed a small stroke. I've been extremely healthy, not one health issue before my headache began. I'm a healthy, fit, mom, wife and medical aesthetician.
Release 10 — day 35, dose 3
Symptoms: Visual disturbances. Scheduled to see a neurologist this Thursday afternoon. I'm desperate for a solution for this.
Release 10 — day 42, dose 3
Release 11 — 6 months, dose 3
Symptoms: Same as last check-in
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 |
|---|---|---|---|---|
| HCVO | Pre-existing disease | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Cerebrovascular accident | · | · | ✓ |
| SD | Constipation | ✓ | ✓ | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Magnetic resonance imaging abnormal | · | · | ✓ |
| SD | Migraine | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Visual impairment | · | · | ✓ |
| SRO | Diarrhoea | · | · | ✓ |
| SRO | Dry eye | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release