6YJ-11103-90011
4 vaccinations
7 coded responses
37 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 299 / SC
- Registered
- 2021-03-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Dose 1 — Pfizer-BioNTech
-
2021-03-18
Registered in v-safe
- 2021-03-18
- 2021-03-19
- 2021-03-20
-
2021-03-21
Survey response — days 1–6 daily, dose 1MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Nausea, DiarrheaFree text: My heartburn is acting up so I think my symptoms are from itMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
- 2021-03-23
- 2021-03-30
-
2021-04-06
Dose 2 — Pfizer-BioNTech
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
-
2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Gastrooesophageal reflux disease — Feeling: Poor · Nausea, Diarrhea · Be unable to do your normal daily activitiesFree text: My acid reflux is bad today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Nausea, Diarrhea · Be unable to do your normal daily activitiesFree text: My acid reflux is bothering me todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Nausea, Diarrhea · Be unable to do your normal daily activitiesFree text: My acid reflux is bad todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-13
-
2021-04-20
Survey response — day 14, dose 2MedDRA: Diarrhoea, Gallbladder disorder, Nausea, Vomiting — Feeling: Poor · 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: I have had vomitting nausea & diarrhea that has been worsening. My doctor thimks i have gall bladder problems.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-20
Report sent to call center — day 14, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-27
Survey response — day 21, dose 2MedDRA: Malaise, Unevaluable event — 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 visitFree text: Symptoms: I have been sick every time I eat for hours. But I am being referred to a GI. I dont think there is any connection here. · Healthcare visit (other): UltrasoundMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-27
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-07-06
- 2021-10-06
-
2021-10-30
Dose 3 — Pfizer-BioNTech
-
2022-04-02
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-04-06
Survey response — 12 months, dose 2MedDRA: Diverticulum — Feeling: FairFree text: I have diverticulosis now.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-18
Dose 4 — Pfizer-BioNTech
- 2022-11-19
- 2022-11-20
- 2022-11-21
- 2022-11-22
- 2022-11-23
- 2022-11-24
- 2022-11-25
- 2022-12-02
- 2022-12-09
- 2022-12-16
- 2022-12-23
- 2022-12-30
- 2023-02-17
- 2023-05-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Pfizer-BioNTech | |
| 2 | 2021-04-06 | Pfizer-BioNTech | |
| 3 | 2021-10-30 | Pfizer-BioNTech | No |
| 4 | 2022-11-18 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 successful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): My heartburn is acting up so I think my symptoms are from it
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): My acid reflux is bad today.
Systemic reaction (other): My acid reflux is bothering me today
Systemic reaction (other): My acid reflux is bad today
Release 7 — day 14, dose 2
Symptoms: I have had vomitting nausea & diarrhea that has been worsening. My doctor thimks i have gall bladder problems.
Release 8 — day 21, dose 2
Symptoms: I have been sick every time I eat for hours. But I am being referred to a GI. I dont think there is any connection here.
Healthcare visit (other): Ultrasound
Release 11 — 12 months, dose 2
Symptoms: I have diverticulosis now.
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Diverticulum | · | · | ✓ |
| SD | Gallbladder disorder | ✓ | ✓ | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Vomiting | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Gastrooesophageal reflux disease | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release