4H6-11073-30414
4 vaccinations
6 coded responses
50 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 933 / CA
- Registered
- 2021-03-06
- Relationship
- Self
- Race
- Other
- Ethnicity
- Hispanic or Latino
Registered dependents
LEL-12017-98568
Child or adolescent in my care · Male · 2021-06-19
54Y-24525-74155
Child or adolescent in my care · Female · 2022-01-09
Timeline
-
2021-03-05
Dose 1 — Pfizer-BioNTech
-
2021-03-06
Registered in v-safe
-
2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction, Pre-existing disease — Feeling: Good · Site: Itching · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: This symptom could be from a an existing symptom I have. I have psoriatic arthritis and I went off of my Humira to take the vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-19
-
2021-03-26
Dose 2 — Pfizer-BioNTech
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
-
2021-04-30
Survey response — day 35, dose 2MedDRA: Headache, Nasal congestion, Oropharyngeal pain — Feeling: FairFree text: Sore throatHeadacheStuffy noseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-07
- 2021-06-27
-
2021-08-29
Dose 3 — Pfizer-BioNTech
- 2021-08-29
- 2021-08-30
- 2021-08-31
- 2021-09-01
- 2021-09-02
-
2021-09-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Joint pains · Be unable to work or attend schoolAdult check-in
-
2021-09-04
Survey response — days 1–6 daily, dose 3MedDRA: Eye irritation — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Burning in the eyesMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-05
Survey response — day 7, dose 3MedDRA: Eye irritation — Feeling: GoodFree text: Burning of the eyesMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-09-12
- 2021-09-19
- 2021-09-26
- 2021-10-03
- 2021-10-10
- 2021-11-30
- 2022-02-27
-
2022-08-27
Dose 4 — Pfizer-BioNTech
- 2022-08-29
-
2022-08-29
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-08-30
Survey response — days 1–6 daily, dose 4MedDRA: Dry mouth, Nasal dryness — Feeling: GoodFree text: Extreme dry mouth and dry nasal passagesMedDRA releases: 2024-11 · check-in free text available
- 2022-08-31
- 2022-09-01
- 2022-09-02
- 2022-09-03
- 2022-09-10
- 2022-09-18
- 2022-09-27
- 2022-10-01
- 2022-10-08
-
2022-11-26
Survey response — 3 months, dose 4MedDRA: Abnormal sensation in eye, Cough, Dyspnoea, Fatigue, Headache, Influenza like illness, Pain, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend school, 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: Headache, cough, chest congestion, flu like symptoms such as achy body and warm eyes. Shortness of breath and fatigue.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-26
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-28
- 2023-02-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Pfizer-BioNTech | |
| 2 | 2021-03-26 | Pfizer-BioNTech | |
| 3 | 2021-08-29 | Pfizer-BioNTech | No |
| 4 | 2022-08-27 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-26 | Unsuccessful |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): This symptom could be from a an existing symptom I have. I have psoriatic arthritis and I went off of my Humira to take the vaccination.
Release 8 — day 35, dose 2
Symptoms: Sore throatHeadacheStuffy nose
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Burning in the eyes
Release 9 — day 7, dose 3
Systemic reaction (other): Burning of the eyes
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Extreme dry mouth and dry nasal passages
Release 12 — 3 months, dose 4
Symptoms: Headache, cough, chest congestion, flu like symptoms such as achy body and warm eyes. Shortness of breath and fatigue.
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 | Abnormal sensation in eye | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Dry mouth | · | · | ✓ |
| SRO | Eye irritation | ✓ | · | ✓ |
| SRO | Nasal dryness | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release