69J-22841-99003
4 vaccinations
2 coded responses
37 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 800 / CO
- Registered
- 2020-12-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Registered dependents
SSW-18575-93638
Child or adolescent in my care · Female · 2022-06-27
2GW-20479-74109
Child or adolescent in my care · Male · 2022-06-27
Z3Q-16715-58412
Child or adolescent in my care · Male · 2022-06-27
Timeline
-
2020-12-19
Registered in v-safe
-
2020-12-19
Dose 1 — Pfizer-BioNTech
- 2020-12-19
-
2020-12-20
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · HeadacheAdult check-in
-
2020-12-21
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tirednessAdult check-in
- 2020-12-22
- 2020-12-23
- 2020-12-24
- 2020-12-25
- 2020-12-26
- 2021-01-02
-
2021-01-08
Dose 2 — Pfizer-BioNTech
- 2021-01-08
-
2021-01-09
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-09
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities1 call case(s)
-
2021-01-10
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
- 2021-01-11
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-22
- 2021-01-31
- 2021-02-03
- 2021-02-05
- 2021-02-12
- 2021-02-21
- 2021-04-09
-
2021-11-03
Dose 3 — Pfizer-BioNTech
- 2022-01-08
-
2022-11-05
Dose 4 — Pfizer-BioNTech
- 2022-11-05
- 2022-11-05
-
2022-11-06
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-11-07
Survey response — days 1–6 daily, dose 4MedDRA: Axillary pain, Oedema peripheral — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: Pain/swelling in armpit areaMedDRA releases: 2024-11 · check-in free text available
-
2022-11-08
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2022-11-10
- 2022-11-11
- 2022-11-14
- 2022-11-19
- 2022-11-26
- 2022-12-03
- 2022-12-10
-
2022-12-17
Survey response — day 42, dose 4MedDRA: Nasopharyngitis, Upper respiratory tract infection — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Cold/URIMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-19 | Pfizer-BioNTech | |
| 2 | 2021-01-08 | Pfizer-BioNTech | |
| 3 | 2021-11-03 | Pfizer-BioNTech | No |
| 4 | 2022-11-05 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-09 | Unsuccessful |
Free text
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Pain/swelling in armpit area
Release 12 — day 42, dose 4
Symptoms: Cold/URI
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 | Nasopharyngitis | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Oedema peripheral | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release