6RQ-93897-15186
2 vaccinations
3 coded responses
16 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 857 / AZ
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-09
Dose 1 — Pfizer-BioNTech
-
2021-03-10
Registered in v-safe
- 2021-03-10
- 2021-03-11
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-25
-
2021-03-30
Dose 2 — Pfizer-BioNTech
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-04-20
- 2021-04-27
-
2021-05-04
Survey response — day 35, dose 2MedDRA: Pre-existing disease, Rash — Feeling: FairFree text: Severe skin breakout. Just starting to heal. But i also have fatty liver disease.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-11
Survey response — day 42, dose 2MedDRA: Arthralgia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Experienced severe pain only in upper left shoulder. Lasted for a week and then culminated in severe psin one night about 1 week ago. Since then no pain. Believe it was upper lung infection. Will check in with doc shortly. Otherwise i feel great.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-11
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-10-01
-
2022-03-30
Survey response — 12 months, dose 2MedDRA: Back disorder, Office visit, Pain — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Severe upper left back. I think its a pinched nerve but going t o get xrays to verify its not my heart. · Healthcare visit (other): Monthly pain clinic check upMedDRA releases: 2024-11 · check-in free text available
-
2022-03-30
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-03-31
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-09 | Pfizer-BioNTech | |
| 2 | 2021-03-30 | Pfizer-BioNTech |
Call center
2 call center cases
2 successful
Free text
Release 8 — day 35, dose 2
Symptoms: Severe skin breakout. Just starting to heal. But i also have fatty liver disease.
Release 8 — day 42, dose 2
Symptoms: Experienced severe pain only in upper left shoulder. Lasted for a week and then culminated in severe psin one night about 1 week ago. Since then no pain. Believe it was upper lung infection. Will check in with doc shortly. Otherwise i feel great.
Release 11 — 12 months, dose 2
Symptoms: Severe upper left back. I think its a pinched nerve but going t o get xrays to verify its not my heart.
Healthcare visit (other): Monthly pain clinic check up
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 | · | · | ✓ |
| HCVO | Pain | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Back disorder | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release