3LV-67621-55000
4 vaccinations
4 coded responses
31 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 191 / PA
- Registered
- 2021-04-13
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-13
Registered in v-safe
-
2021-04-13
Dose 1 — Pfizer-BioNTech
- 2021-04-13
- 2021-04-14
-
2021-04-15
Survey response — days 1–6 daily, dose 1MedDRA: Oropharyngeal pain, Vomiting — Feeling: Fair · VomitingFree text: Sore throat. Vomited once after eating salmon for lunch. But, I feel normal besides that. No other issues.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-20
-
2021-04-27
Survey response — day 14, dose 1MedDRA: Intermenstrual bleeding — Feeling: GoodFree text: Some irregular spotting.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-04
Dose 2 — Pfizer-BioNTech
-
2021-05-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Muscle or body achesAdult check-in
- 2021-05-06
- 2021-05-07
- 2021-05-08
- 2021-05-09
- 2021-05-10
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-06-01
- 2021-06-08
- 2021-06-15
- 2021-08-05
- 2021-11-02
-
2021-12-16
Dose 3 — Pfizer-BioNTech
- 2022-05-04
-
2022-09-29
Dose 4 — ModernaCo-administered: Flu
-
2022-10-15
Survey response — day 14, dose 4MedDRA: Skin reaction — Feeling: GoodFree text: I think I've developed lichen striatus (3 linear short strands) on my top left shoulder and back on the arm I received the covid booster. Online photos of lichen striatus are extremely similar to my cutaneous reaction on my shoulder/back.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-20
Survey response — day 21, dose 4MedDRA: Unevaluable event — Feeling: GoodFree text: I feel 100%. But, I think I have lichen striatus.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-27
- 2022-11-03
- 2022-11-10
- 2022-12-29
- 2023-03-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-13 | Pfizer-BioNTech | |
| 2 | 2021-05-04 | Pfizer-BioNTech | |
| 3 | 2021-12-16 | Pfizer-BioNTech | No |
| 4 | 2022-09-29 | Moderna | Flu |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Sore throat. Vomited once after eating salmon for lunch. But, I feel normal besides that. No other issues.
Release 8 — day 14, dose 1
Symptoms: Some irregular spotting.
Release 12 — day 14, dose 4
Symptoms: I think I've developed lichen striatus (3 linear short strands) on my top left shoulder and back on the arm I received the covid booster. Online photos of lichen striatus are extremely similar to my cutaneous reaction on my shoulder/back.
Release 12 — day 21, dose 4
Symptoms: I feel 100%. But, I think I have lichen striatus.
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 | Intermenstrual bleeding | ✓ | ✓ | ✓ |
| SD | Skin reaction | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Vomiting | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release