6QX-20814-10702
5 vaccinations
9 coded responses
45 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 524 / IA
- Registered
- 2021-04-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-06
Dose 1 — Pfizer-BioNTech
-
2021-04-07
Registered in v-safe
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2021-04-07
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-04-08
- 2021-04-09
-
2021-04-10
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-04-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-04-12
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-04-13
- 2021-04-20
-
2021-04-27
Dose 2 — Pfizer-BioNTech
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2021-04-27
Survey response — day 0, dose 2MedDRA: Nasal congestion, Respiratory tract congestion — Feeling: Good · Site: PainFree text: Nasal & head congestion or stuffinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-28
Survey response — days 1–6 daily, dose 2MedDRA: Head discomfort, Oropharyngeal pain — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessFree text: Stuffed up head and sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-29
Survey response — days 1–6 daily, dose 2MedDRA: Respiratory tract congestion — Feeling: Good · Site: Pain · HeadacheFree text: Head congestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-30
- 2021-05-01
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-06-01
-
2021-06-08
Survey response — day 42, dose 2MedDRA: Blister, Rash pruritic — Feeling: Good · Be unable to do your normal daily activitiesFree text: Itchy rashes and blisters for 2 weeks now. Possibly from poisonous plant or bug contact. This is different from my past skin outbreaks.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-27
Survey response — 3 months, dose 2MedDRA: Blister, Pre-existing disease, Rash pruritic, Sinusitis, Skin weeping — Feeling: Good · Be unable to do your normal daily activitiesFree text: Allergic reaction to poison ivy &/or garlic mustard. Sinusitis, weeping blisters , & itchy rashMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-10-27
-
2021-11-11
Dose 3 — Pfizer-BioNTech
- 2022-04-27
-
2022-05-17
Dose 4 — Pfizer-BioNTech
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2022-05-18
Survey response — days 1–6 daily, dose 4MedDRA: Fatigue — Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activitiesFree text: TiredMedDRA releases: 2024-11 · check-in free text available
- 2022-05-19
- 2022-05-20
- 2022-05-21
- 2022-05-22
- 2022-05-23
- 2022-05-24
- 2022-05-31
- 2022-06-07
- 2022-06-14
- 2022-06-21
- 2022-06-28
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2022-08-16
Survey response — 3 months, dose 4MedDRA: Dermatitis contact, Eczema weeping, Exposure to toxic agent — 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 · Outpatient clinic or urgent care clinic visitFree text: Contact dermatitis, with weeping blisters, from poisonous plantsMedDRA releases: 2024-11 · check-in free text available
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2022-08-16
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-08-17
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2022-08-17
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-11-04
Dose 5 — Moderna
- 2022-11-11
-
2022-11-18
Survey response — day 14, dose 5MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
- 2022-11-25
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2022-12-02
Survey response — day 28, dose 5MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: FairFree text: Sore throat and congestion in headMedDRA releases: 2024-11 · check-in free text available
- 2022-12-09
- 2022-12-16
- 2023-02-03
- 2023-05-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-06 | Pfizer-BioNTech | |
| 2 | 2021-04-27 | Pfizer-BioNTech | |
| 3 | 2021-11-11 | Pfizer-BioNTech | No |
| 4 | 2022-05-17 | Pfizer-BioNTech | No |
| 5 | 2022-11-04 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 8 — day 0, dose 2
Systemic reaction (other): Nasal & head congestion or stuffiness
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Stuffed up head and sore throat
Systemic reaction (other): Head congestion
Release 8 — day 42, dose 2
Symptoms: Itchy rashes and blisters for 2 weeks now. Possibly from poisonous plant or bug contact. This is different from my past skin outbreaks.
Release 9 — 3 months, dose 2
Symptoms: Allergic reaction to poison ivy &/or garlic mustard. Sinusitis, weeping blisters , & itchy rash
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Tired
Release 12 — 3 months, dose 4
Symptoms: Contact dermatitis, with weeping blisters, from poisonous plants
Release 12 — day 14, dose 5
Symptoms: Sore throat
Release 12 — day 28, dose 5
Symptoms: Sore throat and congestion in head
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 | Blister | ✓ | ✓ | ✓ |
| SD | Dermatitis contact | · | · | ✓ |
| SD | Eczema weeping | · | · | ✓ |
| SD | Exposure to toxic agent | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sinusitis | ✓ | · | ✓ |
| SD | Skin weeping | ✓ | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Head discomfort | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release