3XV-33959-16494
5 vaccinations
5 coded responses
22 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 221 / VA
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-21
Registered in v-safe
-
2021-01-21
Dose 1 — Pfizer-BioNTech
- 2021-01-22
-
2021-01-23
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-02-04
-
2021-02-11
Dose 2 — Pfizer-BioNTech
-
2021-02-18
Survey response — day 7, dose 2MedDRA: Fatigue, Feeling hot, Pain — Feeling: Good · Site: PainFree text: Hot was a week ago. I was very tired and a little achey starting at about 24 hours, gone by the next morning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-05-13
-
2021-08-12
Survey response — 6 months, dose 2MedDRA: Dyspnoea, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Discomfort breathing · Healthcare visit (other): Saw my regular internist in personMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-12
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-20
-
2021-08-20
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-08-21
Dose 3 — Pfizer-BioNTech
- 2022-02-11
-
2022-06-15
Dose 4 — Moderna
-
2022-10-14
Dose 5 — ModernaCo-administered: Flu
-
2022-11-05
Survey response — day 21, dose 5MedDRA: COVID-19, Lower respiratory tract infection — Feeling: Good · 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: Had Covid starting 2/24/22. This is the accurate date. The date entered below is false because the system requires a date starting since September. Had long lasting chest cold 10/22, lasted 3 weeks, maybe rsvMedDRA releases: 2024-11 · check-in free text available
-
2022-11-05
Report sent to call center — day 21, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-11-08
-
2022-11-08
Call successfulParticipant prefers to complete VAERS report online
- 2022-11-11
- 2022-11-18
-
2022-11-25
Survey response — day 42, dose 5MedDRA: Chest pain, Cough, Nasopharyngitis, Pain — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Bad cold, deep cough, aches, chest pain when coughingMedDRA releases: 2024-11 · check-in free text available
-
2023-04-14
Survey response — 6 months, dose 5MedDRA: Cough, Nasopharyngitis, Respiratory disorder — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Pfizer-BioNTech | |
| 2 | 2021-02-11 | Pfizer-BioNTech | |
| 3 | 2021-08-21 | Pfizer-BioNTech | No |
| 4 | 2022-06-15 | Moderna | No |
| 5 | 2022-10-14 | Moderna | Flu |
Call center
2 call center cases
2 successful
Free text
Release 4 — day 7, dose 2
Systemic reaction (other): Hot was a week ago. I was very tired and a little achey starting at about 24 hours, gone by the next morning.
Release 9 — 6 months, dose 2
Symptoms: Discomfort breathing
Healthcare visit (other): Saw my regular internist in person
Release 12 — day 21, dose 5
Symptoms: Had Covid starting 2/24/22. This is the accurate date. The date entered below is false because the system requires a date starting since September. Had long lasting chest cold 10/22, lasted 3 weeks, maybe rsv
Release 12 — day 42, dose 5
Symptoms: Bad cold, deep cough, aches, chest pain when coughing
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 | Chest pain | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | ✓ | · | ✓ |
| SD | Lower respiratory tract infection | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release