3RZ-17699-50653
2 vaccinations
4 coded responses
23 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 370 / TN
- Registered
- 2021-07-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
JCY-32521-59179
Adult relative or friend · Male · 2021-07-06
NBP-22459-76593
Adult relative or friend · Female · 2021-07-06
Timeline
-
2021-07-06
Registered in v-safe
-
2021-07-06
Dose 1 — Pfizer-BioNTech
-
2021-07-06
Survey response — day 0, dose 1MedDRA: Pain in extremity — Feeling: GoodFree text: Slightly sore armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-07
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity, Palpitations — Feeling: GoodFree text: Slightly sore arm and heart palpitations at night.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Fatigue or tiredness, NauseaAdult check-in
- 2021-07-09
- 2021-07-10
- 2021-07-11
- 2021-07-12
- 2021-07-13
-
2021-07-20
Survey response — day 14, dose 1MedDRA: Abortion spontaneous, Anembryonic gestation, Office visit — 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 visitFree text: Symptoms: Diagnosed with blighted ovum/miscarriage. · Healthcare visit (other): In-office visit with OB/GYNMedDRA releases: 2024-11 · check-in free text available
-
2021-07-20
Report sent to call center — day 14, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-07-22
-
2021-07-27
Dose 2 — Pfizer-BioNTech
- 2021-07-27
-
2021-07-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-07-29
- 2021-07-30
-
2021-07-31
Survey response — days 1–6 daily, dose 2MedDRA: Breast pain — Feeling: GoodFree text: Slightly sore left breast (had vaccine in left arm)MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-08-01
- 2021-08-02
- 2021-08-03
- 2021-08-10
- 2021-08-17
- 2021-08-24
- 2021-08-31
- 2021-09-07
- 2021-10-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-07-06 | Pfizer-BioNTech | No |
| 2 | 2021-07-27 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-20 | Unsuccessful |
Free text
Release 9 — day 0, dose 1
Systemic reaction (other): Slightly sore arm
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Slightly sore arm and heart palpitations at night.
Release 9 — day 14, dose 1
Symptoms: Diagnosed with blighted ovum/miscarriage.
Healthcare visit (other): In-office visit with OB/GYN
Release 9 — days 1–6 daily, dose 2
Systemic reaction (other): Slightly sore left breast (had vaccine in left arm)
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 | Office visit | · | · | ✓ |
| SD | Abortion spontaneous | · | · | ✓ |
| SD | Anembryonic gestation | · | · | ✓ |
| SRO | Breast pain | ✓ | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release