45A-22432-40001
4 vaccinations
6 coded responses
17 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 606 / IL
- Registered
- 2021-02-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-06
Dose 1 — Pfizer-BioNTech
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2021-02-06
Dose 2 — Pfizer-BioNTech
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2021-02-07
Registered in v-safe
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2021-02-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
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2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Rash pruritic — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Itching with rash (rash actually started the 2nd day in the evening)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
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2021-02-13
Survey response — day 7, dose 2MedDRA: Rash pruritic — Feeling: Good · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Already has been itching with rash. Rash is starting to heal (scab phase now).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
- 2021-08-08
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2021-09-27
Dose 3 — Pfizer-BioNTech
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2021-09-30
Survey response — days 1–6 daily, dose 3MedDRA: Fatigue, Lymphadenopathy, Nausea, Pain — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Today, 9/30/21, is 3 days later than shot. I felt nauseated, achy, & extremely tired on 9/28, less so on 9/29, & less so today. Also seem to have some swollen glands in my neckMedDRA releases: 2024-11 · check-in free text available
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2021-10-01
Survey response — days 1–6 daily, dose 3MedDRA: Adverse reaction — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: More mild than yesterdays.MedDRA releases: 2024-11 · check-in free text available
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2021-10-02
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: GoodFree text: None from vaccines.MedDRA releases: 2024-11 · check-in free text available
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2021-10-18
Survey response — day 21, dose 3MedDRA: Blindness, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Lost 44% of vision in one eye. (Field of vision test results.) · Healthcare visit (other): Ophthalmologist arranged with visits to multiple specialists. Testing to ID cause is ongoing.MedDRA releases: 2024-11 · check-in free text available
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2021-10-18
Report sent to call center — day 21, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-10-21
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2021-10-22
Call successfulParticipant prefers to complete VAERS report online
- 2021-10-25
- 2021-11-01
- 2021-11-08
- 2021-12-27
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2022-02-25
Dose 4 — Pfizer-BioNTech
- 2022-03-28
- 2022-05-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Pfizer-BioNTech | |
| 2 | 2021-02-06 | Pfizer-BioNTech | |
| 3 | 2021-09-27 | Pfizer-BioNTech | No |
| 4 | 2022-02-25 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Itching with rash (rash actually started the 2nd day in the evening)
Release 4 — day 7, dose 2
Systemic reaction (other): Already has been itching with rash. Rash is starting to heal (scab phase now).
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Today, 9/30/21, is 3 days later than shot. I felt nauseated, achy, & extremely tired on 9/28, less so on 9/29, & less so today. Also seem to have some swollen glands in my neck
Systemic reaction (other): More mild than yesterdays.
Systemic reaction (other): None from vaccines.
Release 10 — day 21, dose 3
Symptoms: Lost 44% of vision in one eye. (Field of vision test results.)
Healthcare visit (other): Ophthalmologist arranged with visits to multiple specialists. Testing to ID cause is ongoing.
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 | Blindness | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Nausea | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Rash pruritic | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release