6JR-79073-09814
5 vaccinations
8 coded responses
54 check-ins
7 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 782 / TX
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-20
Dose 1 — Pfizer-BioNTech
-
2021-01-22
Registered in v-safe
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
-
2021-02-03
Survey response — day 14, dose 1MedDRA: Abdominal discomfort, Rash — Feeling: GoodFree text: At 10 days from 1st dose, intestinal distress and face rash that lasted for 24 hours.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
-
2021-02-13
Dose 2 — Pfizer-BioNTech
- 2021-02-17
- 2021-02-18
-
2021-02-19
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Diarrhea, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-02-20
-
2021-02-27
Survey response — day 14, dose 2MedDRA: Diarrhoea, Rash, Reaction to previous exposure to any vaccine — Feeling: GoodFree text: At 10 days after each of my shots, I had diarrhea and a face rash that lasted about 36 hours. Almost the same symptoms both times.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-06
- 2021-03-14
- 2021-03-20
- 2021-03-27
- 2021-05-15
- 2021-08-14
-
2021-10-06
Dose 3 — Pfizer-BioNTech
-
2021-10-07
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-10-08
-
2021-10-09
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-10
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Abdominal painAdult check-in
- 2021-10-11
- 2021-10-12
- 2021-10-13
- 2021-10-20
-
2021-10-27
Survey response — day 21, dose 3MedDRA: Abdominal pain, Diarrhoea, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Abdominal pain and diarrhea · Healthcare visit (other): My primary care doctor visitMedDRA releases: 2024-11 · check-in free text available
-
2021-10-27
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-10-29
- 2021-11-03
-
2021-11-03
Call successfulDoes not wish to fill out VAERS report
- 2021-11-11
- 2021-11-17
- 2022-01-05
- 2022-04-06
-
2022-05-05
Dose 4 — Moderna
- 2022-05-15
- 2022-05-19
- 2022-05-27
- 2022-06-03
-
2022-06-11
Survey response — day 35, dose 4MedDRA: Hospitalisation — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: In hospital with possible colitisMedDRA releases: 2024-11 · check-in free text available
-
2022-06-11
Report sent to call center — day 35, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-06-13
- 2022-06-13
- 2022-06-16
-
2022-08-04
Survey response — 3 months, dose 4MedDRA: Colitis, Hospitalisation, Office visit, Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Symptoms: Hospitalized with colitis in June. Still experiencing symptoms. Also addressing occasional heart palpitations. · Healthcare visit (other): Visits to GI & heart doctors.MedDRA releases: 2024-11 · check-in free text available
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2022-08-04
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-08-05
- 2022-08-05
- 2022-08-05
-
2022-09-16
Dose 5 — Moderna
- 2022-09-16
-
2022-09-17
Survey response — days 1–6 daily, dose 5MedDRA: Erythema — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Red cheeksMedDRA releases: 2024-11 · check-in free text available
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-22
- 2022-09-25
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-10-28
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2022-12-18
Survey response — 3 months, dose 5MedDRA: Cataract operation — Feeling: Good · 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: Cataract SurgeryMedDRA releases: 2024-11 · check-in free text available
-
2022-12-18
Report sent to call center — 3 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-20
- 2022-12-20
- 2022-12-20
-
2023-03-17
Survey response — 6 months, dose 5MedDRA: Cataract, Cataract operation, Colitis, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitMedDRA releases: 2024-11
-
2023-03-17
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2023-03-20
- 2023-03-20
- 2023-03-20
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Pfizer-BioNTech | |
| 2 | 2021-02-13 | Pfizer-BioNTech | |
| 3 | 2021-10-06 | Pfizer-BioNTech | No |
| 4 | 2022-05-05 | Moderna | No |
| 5 | 2022-09-16 | Moderna | No |
Call center
5 call center cases
1 successful · 4 unsuccessful
Free text
Release 3 — day 14, dose 1
Symptoms: At 10 days from 1st dose, intestinal distress and face rash that lasted for 24 hours.
Release 4 — day 14, dose 2
Symptoms: At 10 days after each of my shots, I had diarrhea and a face rash that lasted about 36 hours. Almost the same symptoms both times.
Release 10 — day 21, dose 3
Symptoms: Abdominal pain and diarrhea
Healthcare visit (other): My primary care doctor visit
Release 12 — day 35, dose 4
Symptoms: In hospital with possible colitis
Release 12 — 3 months, dose 4
Symptoms: Hospitalized with colitis in June. Still experiencing symptoms. Also addressing occasional heart palpitations.
Healthcare visit (other): Visits to GI & heart doctors.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Red cheeks
Release 12 — 3 months, dose 5
Symptoms: Cataract Surgery
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 | Office visit | · | · | ✓ |
| SD | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Abdominal pain | · | · | ✓ |
| SD | Cataract | · | · | ✓ |
| SD | Cataract operation | · | · | ✓ |
| SD | Colitis | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Reaction to previous exposure to any vaccine | ✓ | · | ✓ |
| SRO | Erythema | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release