4D3-12170-08066
3 vaccinations
2 coded responses
18 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 554 / MN
- Registered
- 2021-08-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
KL6-23131-16807
Child or adolescent in my care · Female · 2021-08-05
THC-15814-67450
Child or adolescent in my care · Female · 2021-11-12
Timeline
-
2021-04-23
Dose 1 — Pfizer-BioNTech
-
2021-05-14
Dose 2 — Pfizer-BioNTech
-
2021-08-05
Registered in v-safe
- 2021-08-13
- 2021-11-12
-
2021-11-30
Dose 3 — Pfizer-BioNTech
- 2021-11-30
-
2021-12-01
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-12-02
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain — Feeling: Fair · Fatigue or tirednessFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
- 2021-12-03
- 2021-12-04
- 2021-12-05
- 2021-12-06
- 2021-12-07
- 2021-12-14
- 2021-12-21
- 2021-12-28
- 2022-01-04
- 2022-01-11
- 2022-03-01
- 2022-05-31
-
2022-11-30
Survey response — 12 months, dose 3MedDRA: Cough, Headache, Oropharyngeal pain, Pain, Pyrexia — Feeling: Good · 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: Cough, sore throat, headache, body ache, feverMedDRA releases: 2024-11 · check-in free text available
-
2022-11-30
Report sent to call center — 12 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-12-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-23 | Pfizer-BioNTech | No |
| 2 | 2021-05-14 | Pfizer-BioNTech | No |
| 3 | 2021-11-30 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-30 | Successful 2022-12-01 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sore throat
Release 12 — 12 months, dose 3
Symptoms: Cough, sore throat, headache, body ache, fever
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 | Cough | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release