3XV-18124-82491
3 vaccinations
4 coded responses
33 check-ins
3 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 430 / OH
- Registered
- 2021-06-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-06-17
Registered in v-safe
-
2021-06-17
Dose 1 — Pfizer-BioNTech
- 2021-06-17
- 2021-06-18
- 2021-06-19
- 2021-06-20
-
2021-06-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitAdult check-in
-
2021-06-21
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-22
- 2021-06-23
-
2021-06-23
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2021-06-24
- 2021-07-01
-
2021-07-08
Dose 2 — Pfizer-BioNTech
-
2021-07-10
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-07-11
- 2021-07-12
- 2021-07-13
- 2021-07-14
- 2021-07-15
-
2021-07-22
Survey response — day 14, dose 2MedDRA: Herpes zoster, Rash — Feeling: Fair · 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 consultationFree text: Rash down left arm diagnosed as shinglesMedDRA releases: 2024-11 · check-in free text available
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2021-07-22
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 pr1 call case(s)
-
2021-07-26
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2021-07-26
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2021-07-29
Survey response — day 21, dose 2MedDRA: Dermatitis infected — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Rash that became infected.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-07-29
Report sent to call center — day 21, dose 2Be 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)
- 2021-08-05
- 2021-08-12
- 2021-08-19
- 2021-10-09
- 2022-01-06
-
2022-01-17
Dose 3 — Pfizer-BioNTech
-
2022-01-18
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitAdult check-in
-
2022-01-18
Report sent to call center — days 1–6 daily, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-01-19
Call successfulParticipant prefers to complete VAERS report online
-
2022-01-20
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body aches, NauseaAdult check-in
- 2022-01-21
- 2022-01-22
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2022-01-24
Survey response — day 7, dose 3MedDRA: Mastitis — Feeling: Poor · Fever · Chills, Headache, Nausea, Vomiting · Be unable to do your normal daily activitiesFree text: I have mastitis, so likely not an effect of the shotMedDRA releases: 2024-11 · check-in free text available
- 2022-02-02
- 2022-02-07
- 2022-02-14
- 2022-02-21
- 2022-02-28
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2023-01-19
Survey response — 12 months, dose 3MedDRA: Pancreatitis — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitMedDRA releases: 2024-11
-
2023-01-19
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2023-01-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-17 | Pfizer-BioNTech | |
| 2 | 2021-07-08 | Pfizer-BioNTech | No |
| 3 | 2022-01-17 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-21 | Successful 2021-06-23 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2021-07-22 | Successful 2021-07-26 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2021-07-29 | Successful 2021-07-26 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-01-18 | Successful 2022-01-19 |
Participant prefers to complete VAERS report online |
| 2023-01-19 | Unsuccessful |
Free text
Release 9 — day 14, dose 2
Symptoms: Rash down left arm diagnosed as shingles
Release 9 — day 21, dose 2
Symptoms: Rash that became infected.
Release 11 — day 7, dose 3
Systemic reaction (other): I have mastitis, so likely not an effect of the shot
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 | Dermatitis infected | ✓ | · | ✓ |
| SD | Herpes zoster | · | · | ✓ |
| SD | Pancreatitis | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SRO | Mastitis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release