6SM-16389-15670
1 vaccination
2 coded responses
2 check-ins
2 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 190 / PA
- Registered
- 2021-09-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
FU5-30567-33684
Adult relative or friend · Female · 2021-09-12
Timeline
-
2021-08-10
Dose 1 — Pfizer-BioNTech
-
2021-09-12
Registered in v-safe
-
2021-09-12
Survey response — day 28, dose 1MedDRA: Chills, Decreased appetite, Dysphagia, Fatigue, Office visit, Oropharyngeal discolouration, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia, Vomiting — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: The following morning after vaccine had fever of 102.9, chills,body aches, sore discolored throat& couldnt shallow, loss of appetite& vomited when did eat. Sore arm& EXTREME FATIQUE, ALL of which continued for 3weeks at which point went to dr. · Healthcare visit (other): Primary doctorMedDRA releases: 2024-11 · check-in free text available
-
2021-09-12
Report sent to call center — day 28, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-16
Survey response — day 35, dose 1MedDRA: Abdominal pain upper, Cough, Decreased appetite, Dysuria, Gastrointestinal pain, Oropharyngeal pain, Pyrexia, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Fever, cough &sore throat, lack of appetite& bowel/stomach cramps with hot urine · Healthcare visit (other): Called primary 3x- nurse called back wanted to talk to dr. But still have not heard back& did call againMedDRA releases: 2024-11 · check-in free text available
-
2021-09-16
Report sent to call center — day 35, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-10 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 unsuccessful
Free text
Release 9 — day 28, dose 1
Symptoms: The following morning after vaccine had fever of 102.9, chills,body aches, sore discolored throat& couldnt shallow, loss of appetite& vomited when did eat. Sore arm& EXTREME FATIQUE, ALL of which continued for 3weeks at which point went to dr.
Healthcare visit (other): Primary doctor
Release 9 — day 35, dose 1
Symptoms: Fever, cough &sore throat, lack of appetite& bowel/stomach cramps with hot urine
Healthcare visit (other): Called primary 3x- nurse called back wanted to talk to dr. But still have not heard back& did call again
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 | Unevaluable event | · | · | ✓ |
| SD | Abdominal pain upper | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Decreased appetite | · | · | ✓ |
| SD | Dysphagia | · | · | ✓ |
| SD | Dysuria | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Gastrointestinal pain | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oropharyngeal discolouration | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release