4NU-16215-11617
1 vaccination
7 coded responses
7 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 919 / CA
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- N/A
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-13
Dose 1 — Pfizer-BioNTech
-
2021-03-17
Registered in v-safe
-
2021-03-17
Survey response — days 1–6 daily, dose 1MedDRA: Inflammation, Pain — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body achesFree text: Inflamación en la axila y dolor que corre hacia el homo plato izquierdo y piquetes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-18
Survey response — days 1–6 daily, dose 1MedDRA: Flank pain, Swelling — Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains · Be unable to do your normal daily activitiesFree text: Dolor en el busto izquierdo e inflamadoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-19
Survey response — days 1–6 daily, dose 1MedDRA: Axillary pain, Breast pain — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint painsFree text: Dolor en mi axila y busto derechoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-20
Survey response — day 7, dose 1MedDRA: Blister, Pain of skin — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Fatigue or tirednessFree text: No mucha Sensibilidad en la piel en la axila y bubbly.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-27
Survey response — day 14, dose 1MedDRA: Herpes zoster, Immunodeficiency, Office visit, Pain, Unevaluable event — Feeling: Poor · Be unable to work, 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: Symptoms: Me dieron los shingles Se me bajaron las defensasTengo mucho dolor y malestar · Healthcare visit (other): Visita ala clÃnica de dr primarioMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-27
Report sent to call center — day 14, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-03
Survey response — day 21, dose 1MedDRA: Herpes zoster — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: El dÃa 3/23 fui diagnosticada con shingles los sÃntomas empezaron desde el 3/17. por esa razón no fui por la segundaDosis de vacuna contra el covid19 que me tocaba hoy 4/3/21.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-03
Report sent to call center — day 21, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-10
Survey response — day 28, dose 1MedDRA: Herpes zoster, Medical counselling, Pain, Pruritus — Feeling: Fair · Be unable to work, 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: Symptoms: Dolor y comezón por los shingles · Healthcare visit (other): Y por teléfonoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-10
Report sent to call center — day 28, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-18
- 2021-06-18
- 2021-06-18
-
2021-06-18
Callback requested for03:00PM ET
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-13 | Pfizer-BioNTech |
Call center
3 call center cases
3 unsuccessful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Inflamación en la axila y dolor que corre hacia el homo plato izquierdo y piquetes.
Systemic reaction (other): Dolor en el busto izquierdo e inflamado
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Dolor en mi axila y busto derecho
Release 6 — day 7, dose 1
Systemic reaction (other): No mucha Sensibilidad en la piel en la axila y bubbly.
Release 6 — day 14, dose 1
Symptoms: Me dieron los shingles Se me bajaron las defensasTengo mucho dolor y malestar
Healthcare visit (other): Visita ala clÃnica de dr primario
Release 6 — day 21, dose 1
Symptoms: El dÃa 3/23 fui diagnosticada con shingles los sÃntomas empezaron desde el 3/17. por esa razón no fui por la segundaDosis de vacuna contra el covid19 que me tocaba hoy 4/3/21.
Release 7 — day 28, dose 1
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 | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Herpes zoster | ✓ | ✓ | ✓ |
| SD | Immunodeficiency | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Unevaluable event | ○ | ✓ | ○ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Blister | ✓ | ✓ | ✓ |
| SRO | Breast pain | ✓ | ✓ | ✓ |
| SRO | Flank pain | ✓ | ✓ | ✓ |
| SRO | Inflammation | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain of skin | ✓ | ✓ | ✓ |
| SRO | Swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release