75N-11769-10521
2 vaccinations
3 coded responses
21 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 021 / MA
- Registered
- 2021-04-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-28
Dose 1 — Pfizer-BioNTech
-
2021-04-30
Registered in v-safe
- 2021-04-30
- 2021-05-01
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-05
- 2021-05-12
-
2021-05-19
Dose 2 — Pfizer-BioNTech
-
2021-05-20
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-05-21
- 2021-05-23
- 2021-05-24
- 2021-05-25
- 2021-05-26
- 2021-06-02
- 2021-06-09
-
2021-06-16
Survey response — day 28, dose 2MedDRA: Abortion spontaneous — Feeling: Fair · 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: Miscarriage (~5 weeks)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-16
Report sent to call center — day 28, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-06-23
- 2021-06-23
-
2021-06-30
Survey response — day 42, dose 2MedDRA: Oropharyngeal pain — Feeling: FairFree text: Sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-08-20
Survey response — 3 months, dose 2MedDRA: Ageusia, Anosmia, COVID-19, Cough, Headache, Lethargy, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: COVID-19 diagnosis via PCR testsymptoms started Monday, 8/16 PM: headache, fever, congestion, cough, lethargy, loss of taste/smell. Today, Friday, 8/20 symptoms are congestion, cough, lethargy, loss of taste/smell all manageableMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-11-17
- 2022-05-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-28 | Pfizer-BioNTech | |
| 2 | 2021-05-19 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-16 | Unsuccessful |
Free text
Release 9 — day 28, dose 2
Symptoms: Miscarriage (~5 weeks)
Release 9 — day 42, dose 2
Symptoms: Sore throat
Release 9 — 3 months, dose 2
Symptoms: COVID-19 diagnosis via PCR testsymptoms started Monday, 8/16 PM: headache, fever, congestion, cough, lethargy, loss of taste/smell. Today, Friday, 8/20 symptoms are congestion, cough, lethargy, loss of taste/smell all manageable
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 | Abortion spontaneous | ✓ | ✓ | ✓ |
| SD | Ageusia | ✓ | · | ✓ |
| SD | Anosmia | ✓ | · | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SD | COVID-19 | ✓ | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Lethargy | ✓ | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | · | ✓ |
| SD | Respiratory tract congestion | ✓ | · | ✓ |
| SD | SARS-CoV-2 test positive | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release