5E3-19256-80087
3 vaccinations
3 coded responses
16 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 454 / OH
- Registered
- 2021-10-30
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Registered dependents
A2H-30646-07931
Child or adolescent in my care · Female · 2021-11-14
YU3-32552-34555
Child or adolescent in my care · Male · 2021-11-14
Timeline
-
2021-02-06
Dose 1 — Pfizer-BioNTech
-
2021-02-27
Dose 2 — Pfizer-BioNTech
-
2021-10-30
Registered in v-safe
-
2021-10-30
Dose 3 — Pfizer-BioNTech
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
-
2021-11-06
Survey response — day 7, dose 3MedDRA: Paranasal sinus discomfort — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessFree text: Sinus pressureMedDRA releases: 2024-11 · check-in free text available
-
2021-11-14
Survey response — day 14, dose 3MedDRA: Ear infection, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sinus infection, ear infectionMedDRA releases: 2024-11 · check-in free text available
-
2021-11-14
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-11-16
Call successfulParticipant prefers to complete VAERS report online
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2021-12-11
- 2022-01-31
- 2022-04-30
-
2022-10-30
Survey response — 12 months, dose 3MedDRA: COVID-19, Ear infection, Office visit — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: I was diagnosed with Covid on 10/12/22. I was recovering from an ear infection at the same time, and my doctor was worried about bronchitis.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-30
Report sent to call center — 12 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 prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-10-31
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 | 2021-02-06 | Pfizer-BioNTech | No |
| 2 | 2021-02-27 | Pfizer-BioNTech | No |
| 3 | 2021-10-30 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-14 | Successful 2021-11-16 |
Participant prefers to complete VAERS report online |
| 2022-10-30 | Successful 2022-10-31 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 10 — day 7, dose 3
Systemic reaction (other): Sinus pressure
Release 10 — day 14, dose 3
Symptoms: Sinus infection, ear infection
Release 12 — 12 months, dose 3
Symptoms: I was diagnosed with Covid on 10/12/22. I was recovering from an ear infection at the same time, and my doctor was worried about bronchitis.
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 | COVID-19 | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Paranasal sinus discomfort | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release