64U-98389-30139
3 vaccinations
5 coded responses
6 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 12-15
- ZIP prefix
- 551 / MN
- Registered
- 2022-01-15
- Relationship
- Child or adolescent in my care
- Guardian
- TB9-43911-89010
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-07-06
Dose 1 — Pfizer-BioNTech
-
2021-07-29
Dose 2 — Pfizer-BioNTech
-
2022-01-13
Dose 3 — Pfizer-BioNTech
-
2022-01-15
Registered in v-safe
-
2022-01-15
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Emergency care, Hypersensitivity, Self-medication — Feeling: Poor · Site: Itching · Fever · Be unable to do your normal daily activitiesFree text: (b)(6) had an allergic reaction to the booster shot. She has been to the emergency room twice since the shot. I have her on allergy medication for every six hours. She's been sleeping throughout the day.MedDRA releases: 2024-11 · check-in free text available
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2022-01-16
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Asthenia, Loss of personal independence in daily activities, Rash, Self-medication, Swelling face — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: Her body continues to react to the shot. She woke up today with swollen face, rash all over her face and neck. Allergy medicine seems to help. She's is weak and not able to be productiveMedDRA releases: 2024-11 · check-in free text available
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2022-01-17
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Swelling face — Feeling: GoodFree text: Some swelling in the face, but overall she's doing better.MedDRA releases: 2024-11 · check-in free text available
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2022-01-18
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Hypersensitivity, Office visit — Feeling: Poor · Headache, Fatigue or tiredness · 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 visit, Emergency room or emergency department visitFree text: She experienced another allergy reaction. Her Dr. prescribed her oral steroid and hydroxyzine for next 5 daysMedDRA releases: 2024-11 · check-in free text available
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2022-01-18
Report sent to call center — days 1–6 daily, dose 3, dependentBe 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 · Emergency room or emergency department visit · 1 call case(s)
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2022-01-19
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Unevaluable event — Feeling: FairFree text: Current medication is making her sick. Overall she better and attending school.MedDRA releases: 2024-11 · check-in free text available
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2022-01-19
Call successfulParticipant prefers to complete VAERS report online
- 2022-01-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-07-06 | Pfizer-BioNTech | No |
| 2 | 2021-07-29 | Pfizer-BioNTech | No |
| 3 | 2022-01-13 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 10 — days 1–6 daily, dose 3, dependent
Systemic reaction (other): (b)(6) had an allergic reaction to the booster shot. She has been to the emergency room twice since the shot. I have her on allergy medication for every six hours. She's been sleeping throughout the day.
redacted (b)(6)
Systemic reaction (other): Her body continues to react to the shot. She woke up today with swollen face, rash all over her face and neck. Allergy medicine seems to help. She's is weak and not able to be productive
Systemic reaction (other): Some swelling in the face, but overall she's doing better.
Systemic reaction (other): She experienced another allergy reaction. Her Dr. prescribed her oral steroid and hydroxyzine for next 5 days
Systemic reaction (other): Current medication is making her sick. Overall she better and attending school.
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 |
|---|---|---|---|---|
| SRO | Asthenia | · | · | ✓ |
| SRO | Emergency care | · | · | ✓ |
| SRO | Hypersensitivity | · | · | ✓ |
| SRO | Loss of personal independence in daily activities | · | · | ✓ |
| SRO | Office visit | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Swelling face | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release