7ZZ-19699-34246
5 vaccinations
4 coded responses
36 check-ins
4 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 940 / CA
- Registered
- 2020-12-22
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Registered dependents
5NM-69687-30642
Child or adolescent in my care · Female · 2022-06-24
Z3U-77101-78630
Child or adolescent in my care · Male · 2022-10-30
Timeline
-
2020-12-22
Registered in v-safe
-
2020-12-22
Dose 1 — Pfizer-BioNTech
- 2020-12-22
- 2020-12-24
- 2020-12-25
- 2020-12-26
- 2020-12-28
- 2020-12-31
- 2021-01-05
-
2021-01-12
Dose 2 — Pfizer-BioNTech
- 2021-01-12
-
2021-01-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-13
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities1 call case(s)
-
2021-01-15
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-15
Report sent to call center — days 1–6 daily, dose 2Be unable to work · Be unable to do your normal daily activities1 call case(s)
- 2021-01-16
-
2021-01-18
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-01-19
-
2021-01-27
Survey response — 14 day, dose 2MedDRA: Pyrexia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-01-27
Report sent to call center — 14 day, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-02
Survey response — 21 day, dose 2MedDRA: Stillbirth — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-02
Report sent to call center — 21 day, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-02-02
Call successfulDoes not wish to fill out VAERS report
-
2021-02-02
Call successfulDoes not wish to fill out VAERS report
-
2021-02-02
Call successfulDoes not wish to fill out VAERS report
-
2021-02-02
Call successfulDoes not wish to fill out VAERS report
- 2021-02-11
- 2021-02-16
- 2021-02-23
- 2021-04-13
- 2021-07-13
-
2021-08-14
Dose 3 — Pfizer-BioNTech
- 2021-09-30
- 2021-11-13
- 2022-02-12
-
2022-05-04
Dose 4 — Pfizer-BioNTech
- 2022-08-03
-
2022-09-10
Dose 5 — Moderna
-
2022-09-12
Survey response — days 1–6 daily, dose 5MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
-
2022-09-13
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-09-14
- 2022-09-16
- 2022-09-17
- 2022-09-24
- 2022-10-01
- 2022-10-08
-
2022-10-15
Survey response — 35 day, dose 5MedDRA: Pneumonia bacterial — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11 · check-in answers available
-
2022-10-15
Report sent to call center — 35 day, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-10-17
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-22
- 2022-12-10
- 2023-03-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-22 | Pfizer-BioNTech | |
| 2 | 2021-01-12 | Pfizer-BioNTech | |
| 3 | 2021-08-14 | Pfizer-BioNTech | No |
| 4 | 2022-05-04 | Pfizer-BioNTech | No |
| 5 | 2022-09-10 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-01-13 | Successful 2021-02-02 |
Does not wish to fill out VAERS report |
| 2021-01-15 | Successful 2021-02-02 |
Does not wish to fill out VAERS report |
| 2021-01-27 | Successful 2021-02-02 |
Does not wish to fill out VAERS report |
| 2021-02-02 | Successful 2021-02-02 |
Does not wish to fill out VAERS report |
| 2022-10-15 | Successful 2022-10-17 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 2
Symptoms: Fevers at night , low platelets
Release 3
Symptoms: stillborn baby at 20 weeks
Release 12
Systemic reaction (other): dizziness
Symptoms: Bacterial pneumonia
Free-text releases are not linked to a specific 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 | Pneumonia bacterial | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Stillbirth | ✓ | ✓ | ✓ |
| SRO | Dizziness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release