3QV-13516-85591
2 vaccinations
5 coded responses
10 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 236 / VA
- Registered
- 2021-03-29
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Hispanic or Latino
Timeline
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2021-03-15
Dose 1 — Pfizer-BioNTech
-
2021-03-29
Registered in v-safe
-
2021-04-02
Dose 2 — Pfizer-BioNTech
- 2021-04-02
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2021-04-02
Health check-in — day 0, dose 2Feeling: Poor · Site: Pain · Muscle or body aches, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Muscle or body aches, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-04-17
Survey response — day 14, dose 2MedDRA: Thrombosis — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Blood clot in legsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-17
Report sent to call center — day 14, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
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2021-04-23
Survey response — day 21, dose 2MedDRA: Dyspnoea, Thrombosis — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Trouble breathing. Clot on legMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-23
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-30
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2021-05-09
Survey response — day 35, dose 2MedDRA: Dyspnoea — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Shortness of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
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2021-05-17
Survey response — day 42, dose 2MedDRA: Chest pain, Dyspnoea, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Still trouble breathing..pain chest . Sore throat. Breathing problems at nightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-10-01
Survey response — 6 months, dose 2MedDRA: Chest pain, Dyspnoea, Thrombosis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Chest pain shortness of breath blood clot in the legMedDRA releases: 2024-11 · check-in free text available
- 2022-11-30
- 2022-11-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-15 | Pfizer-BioNTech | |
| 2 | 2021-04-02 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-17 | Unsuccessful | |
| 2021-04-23 | Unsuccessful |
Free text
Release 7 — day 14, dose 2
Symptoms: Blood clot in legs
Release 7 — day 21, dose 2
Symptoms: Trouble breathing. Clot on leg
Release 8 — day 35, dose 2
Symptoms: Shortness of breath
Release 8 — day 42, dose 2
Symptoms: Still trouble breathing..pain chest . Sore throat. Breathing problems at night
Release 9 — 6 months, dose 2
Symptoms: Chest pain shortness of breath blood clot in the leg
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 | Chest pain | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Thrombosis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release