MC6-28665-75151
4 vaccinations
6 coded responses
36 check-ins
5 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 775 / TX
- Registered
- 2021-02-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
MV4-20809-58636
Child or adolescent in my care · Male · 2022-06-24
Timeline
-
2021-02-12
Registered in v-safe
-
2021-02-12
Dose 1 — Pfizer-BioNTech
-
2021-02-13
Survey response — days 1–6 daily, dose 1MedDRA: Lymph node pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: Pain near collarbone, possibly deltopectoral nodeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-26
-
2021-03-05
Dose 2 — Pfizer-BioNTech
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-06-06
- 2021-09-05
-
2021-09-16
Dose 3 — Pfizer-BioNTech
-
2022-03-07
Survey response — 12 months, dose 2MedDRA: Cough, Pyrexia, Respiratory tract congestion — Feeling: Good · 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: Fever, cough, congestionMedDRA releases: 2024-11 · check-in free text available
-
2022-03-07
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-03-09
Call successfulDoes not wish to fill out VAERS report
-
2022-09-16
Survey response — 12 months, dose 3MedDRA: Abortion spontaneous — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, HospitalizationFree text: Pregnancy and miscarriage.MedDRA releases: 2024-11 · check-in free text available
-
2022-09-16
Report sent to call center — 12 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
-
2022-09-19
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-09-29
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-10-03
- 2022-10-04
- 2022-10-05
- 2022-10-06
- 2022-10-13
-
2022-10-20
Survey response — day 21, dose 4MedDRA: Oropharyngeal pain — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
- 2022-10-27
- 2022-11-03
- 2022-11-12
-
2022-12-29
Survey response — 3 months, dose 4MedDRA: Sinus congestion — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sinus congestionMedDRA releases: 2024-11 · check-in free text available
-
2023-03-30
Survey response — 6 months, dose 4MedDRA: Diarrhoea, Enterovirus infection, Pyrexia, Respiratory tract congestion, Vomiting — 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 · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-03-30
Report sent to call center — 6 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-03-31
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-12 | Pfizer-BioNTech | |
| 2 | 2021-03-05 | Pfizer-BioNTech | |
| 3 | 2021-09-16 | Pfizer-BioNTech | No |
| 4 | 2022-09-29 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-07 | Successful 2022-03-09 |
Does not wish to fill out VAERS report |
| 2022-09-16 | Successful 2022-09-19 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2023-03-30 | Successful 2023-03-31 |
Completed over the phone |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Pain near collarbone, possibly deltopectoral node
Release 11 — 12 months, dose 2
Symptoms: Fever, cough, congestion
Release 12 — 12 months, dose 3
Symptoms: Pregnancy and miscarriage.
Release 12 — day 21, dose 4
Symptoms: Sore throat
Release 12 — 3 months, dose 4
Symptoms: Sinus congestion
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 | Cough | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Enterovirus infection | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release