6KA-14111-93558
5 vaccinations
13 coded responses
47 check-ins
12 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 983 / WA
- Registered
- 2021-03-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-13
Registered in v-safe
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2021-03-13
Dose 1 — Pfizer-BioNTech
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2021-03-13
Survey response — day 0, dose 1MedDRA: Abnormal sensation in eye, Asthenopia — Feeling: Good · HeadacheFree text: eyes feel a little heavy and warm, like when a fever is coming on.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
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2021-03-19
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Vertigo — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Dizzy, vertigoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-20
Health check-in — day 7, dose 1Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-27
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2021-04-03
Dose 2 — Pfizer-BioNTech
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2021-04-03
Survey response — day 0, dose 2MedDRA: Asthenopia — Feeling: Fair · Headache, Fatigue or tirednessFree text: eyes feel heavyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Feeling hot — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Feel like I have a fever, but I don't.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-10
- 2021-04-17
- 2021-04-24
- 2021-05-03
- 2021-05-08
- 2021-05-15
- 2021-07-03
- 2021-10-02
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2021-10-04
Dose 3 — Pfizer-BioNTechCo-administered: Flu
- 2021-10-04
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2021-10-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-10-06
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to work or attend schoolAdult check-in
- 2021-10-07
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2021-10-08
Survey response — days 1–6 daily, dose 3MedDRA: Diarrhoea — Feeling: Good · Headache, Diarrhea · Be unable to work or attend schoolFree text: I forgot to check diarrhea yesterday. It was ModerateMedDRA releases: 2024-11 · check-in free text available
- 2021-10-09
- 2021-10-11
- 2021-10-18
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2021-10-25
Survey response — day 21, dose 3MedDRA: Gastrointestinal disorder, Gastrooesophageal reflux disease — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Stomach/GERD issues. I don't think its related to the immunization.MedDRA releases: 2024-11 · check-in free text available
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2021-10-25
Report sent to call center — day 21, dose 3Be unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-11-01
- 2021-11-01
- 2021-11-04
- 2021-11-08
- 2021-11-15
- 2022-01-03
- 2022-04-04
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2022-04-05
Dose 4 — Pfizer-BioNTech
- 2022-04-14
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2022-04-19
Survey response — day 14, dose 4MedDRA: Fall, Reaction to previous exposure to any vaccine, Vertigo — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I've been struggling with Vertigo since 4/14. Got the covid booster 4/5. I don't know if its related, but it happened after my last covid shot also. I didn't make the connection last time, so don't remember if I even reported it! It caused a Fall!MedDRA releases: 2024-11 · check-in free text available
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2022-04-26
Survey response — day 21, dose 4MedDRA: Asthma, Sinus congestion — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sinus stuffiness, asthma symptoms,MedDRA releases: 2024-11 · check-in free text available
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2022-05-03
Survey response — day 28, dose 4MedDRA: COVID-19, Facial pain, Fatigue, Headache, Sinus congestion, Vertigo — Feeling: Poor · Be unable to do your normal daily activitiesFree text: COVID positive, Sinus congestion, headache, face ache, Vertigo, fatigue.MedDRA releases: 2024-11 · check-in free text available
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2022-05-10
Survey response — day 35, dose 4MedDRA: Asthma, COVID-19 — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Asthma is a daily problem sinve having COVID.MedDRA releases: 2024-11 · check-in free text available
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2022-05-10
Report sent to call center — day 35, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-05-11
Call successfulParticipant prefers to complete VAERS report online
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2022-05-17
Survey response — day 42, dose 4MedDRA: Asthma, Pleurisy, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Asthma Exacerbation, PleurisyMedDRA releases: 2024-11 · check-in free text available
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2022-05-17
Report sent to call center — day 42, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
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2022-05-18
Call successfulReported to VAERS voluntarily prior to GDIT contact
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2022-07-05
Survey response — 3 months, dose 4MedDRA: Blood creatinine increased, Blood potassium decreased, Emergency care, Glomerular filtration rate decreased, Office visit, Renal impairment — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Kidney function declined with COVID. Was discovered in Urgent Care/ER on 5/14/2022. Primary care DR informed me 6/8. GFR was 48. Creatinine was high. Potassium low. This week labs show all numbers have returned to just barely within normal range. · Healthcare visit (other): Lab multiple visits tooMedDRA releases: 2024-11 · check-in free text available
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2022-07-05
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-07-06
Call successfulParticipant prefers to complete VAERS report online
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2022-09-10
Dose 5 — Pfizer-BioNTech
- 2022-10-04
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2023-04-05
Survey response — 12 months, dose 4MedDRA: COVID-19, Renal impairment — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-04-05
Report sent to call center — 12 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2023-04-06
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-13 | Pfizer-BioNTech | |
| 2 | 2021-04-03 | Pfizer-BioNTech | |
| 3 | 2021-10-04 | Pfizer-BioNTech | Flu |
| 4 | 2022-04-05 | Pfizer-BioNTech | No |
| 5 | 2022-09-10 | Pfizer-BioNTech | No |
Call center
5 call center cases
5 successful
VAERS report filed, before or during a call: 2
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): eyes feel a little heavy and warm, like when a fever is coming on.
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Dizzy, vertigo
Release 6 — day 0, dose 2
Systemic reaction (other): eyes feel heavy
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Feel like I have a fever, but I don't.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I forgot to check diarrhea yesterday. It was Moderate
Release 10 — day 21, dose 3
Symptoms: Stomach/GERD issues. I don't think its related to the immunization.
Release 11 — day 14, dose 4
Symptoms: I've been struggling with Vertigo since 4/14. Got the covid booster 4/5. I don't know if its related, but it happened after my last covid shot also. I didn't make the connection last time, so don't remember if I even reported it! It caused a Fall! cut off by CDC
Release 11 — day 21, dose 4
Symptoms: Sinus stuffiness, asthma symptoms,
Release 11 — day 28, dose 4
Symptoms: COVID positive, Sinus congestion, headache, face ache, Vertigo, fatigue.
Release 11 — day 35, dose 4
Symptoms: Asthma is a daily problem sinve having COVID.
Release 11 — day 42, dose 4
Symptoms: Asthma Exacerbation, Pleurisy
Release 12 — 3 months, dose 4
Symptoms: Kidney function declined with COVID. Was discovered in Urgent Care/ER on 5/14/2022. Primary care DR informed me 6/8. GFR was 48. Creatinine was high. Potassium low. This week labs show all numbers have returned to just barely within normal range.
Healthcare visit (other): Lab multiple visits too
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 | Asthma | · | · | ✓ |
| SD | Blood creatinine increased | · | · | ✓ |
| SD | Blood potassium decreased | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Facial pain | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Gastrooesophageal reflux disease | · | · | ✓ |
| SD | Glomerular filtration rate decreased | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Pleurisy | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SD | Renal impairment | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Vertigo | · | · | ✓ |
| SRO | Abnormal sensation in eye | ✓ | ✓ | ✓ |
| SRO | Asthenopia | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Vertigo | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release