PDF-13708-02479
4 vaccinations
5 coded responses
28 check-ins
4 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 314 / GA
- Registered
- 2020-12-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
SY7-25562-65355
Child or adolescent in my care · Male · 2022-06-29
Timeline
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2020-12-15
Registered in v-safe
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2020-12-15
Dose 1 — Pfizer-BioNTech
- 2020-12-15
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2020-12-16
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Headache, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2020-12-16
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
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2020-12-17
Survey response — days 1–6 daily, dose 1MedDRA: Migraine — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: One of the nurse practitioners I work with gave me a shot of toradol to break the migraine I have.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2020-12-17
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2020-12-17
Call successfulParticipant prefers to complete VAERS report online
- 2020-12-18
- 2020-12-18
- 2020-12-19
- 2020-12-20
- 2020-12-21
- 2020-12-22
-
2020-12-23
Call successfulParticipant prefers to complete VAERS report online
- 2020-12-29
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2021-01-04
Dose 2 — Pfizer-BioNTech
- 2021-01-07
- 2021-01-08
- 2021-01-10
- 2021-01-11
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2021-01-18
Survey response — day 14, dose 2MedDRA: Nausea, Vomiting — Feeling: Good · Be unable to do your normal daily activitiesFree text: I had nausea and vomiting on 1/16/21 for only 1 day but I think it was from being hungover.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-18
Report sent to call center — day 14, dose 2Be unable to do your normal daily activities1 call case(s)
- 2021-01-19
- 2021-02-01
- 2021-02-08
- 2021-02-15
- 2021-04-05
- 2021-07-05
-
2021-09-02
Dose 3 — Moderna
- 2021-09-28
-
2021-09-30
Survey response — day 28, dose 3MedDRA: Pregnancy — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Headache and nausea today. Probably pregnancy related.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-07
- 2021-10-16
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2021-12-02
Survey response — 3 months, dose 3MedDRA: Ear infection, Nasopharyngitis, Tympanic membrane perforation — 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 visitFree text: Common cold and ear infection with ruptured eardrum. I'm sure it has nothing to do with the vaccine though.MedDRA releases: 2024-11 · check-in free text available
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2021-12-02
Report sent to call center — 3 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 · 1 call case(s)
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2021-12-03
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-03
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2022-04-04
Dose 4 — Pfizer-BioNTech
- 2022-07-06
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2023-04-04
Survey response — 12 months, dose 4MedDRA: Hand-foot-and-mouth disease, Nasopharyngitis, Viral infection — 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 visitMedDRA releases: 2024-11
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2023-04-04
Report sent to call center — 12 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)
- 2023-04-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-15 | Pfizer-BioNTech | |
| 2 | 2021-01-04 | Pfizer-BioNTech | |
| 3 | 2021-09-02 | Moderna | No |
| 4 | 2022-04-04 | Pfizer-BioNTech | No |
Call center
5 call center cases
3 successful · 1 unsuccessful · 1 priority 2/3 (triaged and no follow up)
Free text
Release 1 — days 1–6 daily, dose 1
Healthcare visit (other): One of the nurse practitioners I work with gave me a shot of toradol to break the migraine I have.
Release 2 — day 14, dose 2
Symptoms: I had nausea and vomiting on 1/16/21 for only 1 day but I think it was from being hungover.
Release 9 — day 28, dose 3
Symptoms: Headache and nausea today. Probably pregnancy related.
Release 10 — 3 months, dose 3
Symptoms: Common cold and ear infection with ruptured eardrum. I'm sure it has nothing to do with the vaccine though.
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 | Migraine | ✓ | ✓ | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Hand-foot-and-mouth disease | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Tympanic membrane perforation | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SD | Vomiting | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release