4AW-27898-23475
4 vaccinations
7 coded responses
35 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 782 / TX
- Registered
- 2020-12-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Registered dependents
EPS-11106-40190
Adult relative or friend · Female · 2022-04-14
Timeline
-
2020-12-30
Registered in v-safe
-
2020-12-30
Dose 1 — Pfizer-BioNTech
- 2020-12-30
- 2020-12-31
-
2021-01-01
Survey response — days 1–6 daily, dose 1MedDRA: Exposure to SARS-CoV-2 — Feeling: Good · ChillsFree text: No symptoms but exposed to Covid-19 after I received the Vaccine 12/30/2020. Just notified today. Will test 1/5/2021.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-02
- 2021-01-03
- 2021-01-06
- 2021-01-13
- 2021-01-21
-
2021-01-27
Dose 2 — Pfizer-BioNTech
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
-
2021-02-03
Health check-in — day 7, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-10
- 2021-02-19
- 2021-02-24
- 2021-03-03
-
2021-03-10
Survey response — day 42, dose 2MedDRA: Arthralgia, Inflammation, Joint swelling — Feeling: GoodFree text: Increased inflammation in my right leg. My knee, my ankle, my trochanter hip pain. All over the last month has increasingly gotten worse, so much that my right knee is swollen 1 inch larger than my left.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-28
Survey response — 3 months, dose 2MedDRA: Urinary tract infection — Feeling: GoodFree text: UTIMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-29
-
2021-08-25
Dose 3 — Pfizer-BioNTech
- 2021-09-29
-
2021-10-07
Survey response — day 42, dose 3MedDRA: Knee arthroplasty — Feeling: GoodFree text: Total right knee replacement needed.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-24
Survey response — 3 months, dose 3MedDRA: Loss of consciousness, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Knee replacement needed but delayed due to blacking out while driving. Now under care of Cardiologist to determine why.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-24
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-01-15
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-02-23
Survey response — 6 months, dose 3MedDRA: Knee arthroplasty — 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 · HospitalizationFree text: Total knee replacement.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-23
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
- 2022-02-24
-
2022-04-01
Dose 4 — Pfizer-BioNTech
- 2022-04-14
- 2022-04-15
-
2022-04-22
Survey response — day 21, dose 4MedDRA: Office visit, Squamous cell carcinoma — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Squamous cell carcinoma · Healthcare visit (other): Detected during 6 month dermatology apptMedDRA releases: 2024-11 · check-in free text available
-
2022-04-22
Report sent to call center — day 21, dose 4Get care from a doctor or other healthcare professional1 call case(s)
-
2022-04-26
Call successfulDoes not wish to fill out VAERS report
- 2022-05-01
- 2022-05-13
- 2022-07-03
- 2022-09-30
- 2023-04-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Pfizer-BioNTech | |
| 2 | 2021-01-27 | Pfizer-BioNTech | |
| 3 | 2021-08-25 | Pfizer-BioNTech | No |
| 4 | 2022-04-01 | Pfizer-BioNTech | No |
Call center
3 call center cases
3 successful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): No symptoms but exposed to Covid-19 after I received the Vaccine 12/30/2020. Just notified today. Will test 1/5/2021.
Release 5 — day 42, dose 2
Symptoms: Increased inflammation in my right leg. My knee, my ankle, my trochanter hip pain. All over the last month has increasingly gotten worse, so much that my right knee is swollen 1 inch larger than my left.
Release 8 — 3 months, dose 2
Symptoms: UTI
Release 10 — day 42, dose 3
Symptoms: Total right knee replacement needed.
Release 10 — 3 months, dose 3
Symptoms: Knee replacement needed but delayed due to blacking out while driving. Now under care of Cardiologist to determine why.
Release 11 — 6 months, dose 3
Symptoms: Total knee replacement.
Release 11 — day 21, dose 4
Symptoms: Squamous cell carcinoma
Healthcare visit (other): Detected during 6 month dermatology appt
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Inflammation | ✓ | ✓ | ✓ |
| SD | Joint swelling | ✓ | ✓ | ✓ |
| SD | Knee arthroplasty | · | · | ✓ |
| SD | Loss of consciousness | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Squamous cell carcinoma | · | · | ✓ |
| SD | Urinary tract infection | ✓ | ✓ | ✓ |
| SRO | Exposure to SARS-CoV-2 | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release