SDM-12397-35434
4 vaccinations
5 coded responses
40 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 920 / CA
- Registered
- 2021-03-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-28
Dose 1 — Pfizer-BioNTech
-
2021-03-21
Dose 2 — Pfizer-BioNTech
-
2021-03-22
Registered in v-safe
-
2021-03-22
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-04-04
- 2021-04-11
- 2021-04-19
- 2021-04-25
- 2021-05-02
- 2021-06-20
- 2021-09-21
-
2021-12-27
Dose 3 — Moderna
- 2021-12-27
-
2021-12-28
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2021-12-29
-
2021-12-30
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2021-12-31
- 2022-01-01
- 2022-01-02
- 2022-01-03
- 2022-01-10
- 2022-01-17
- 2022-01-24
- 2022-01-31
-
2022-02-07
Survey response — 42 day, dose 3MedDRA: Procedural complication — 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 visit, Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11 · check-in answers available
-
2022-02-07
Report sent to call center — 42 day, dose 3Be 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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-02-09
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-28
- 2022-06-27
-
2022-12-01
Dose 4 — Pfizer-BioNTech
-
2022-12-03
Survey response — days 1–6 daily, dose 4MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain · HeadacheMedDRA releases: 2024-11 · check-in answers available
- 2022-12-04
-
2022-12-05
Survey response — days 1–6 daily, dose 4MedDRA: Lymphadenopathy — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
- 2022-12-07
- 2022-12-08
-
2022-12-16
Survey response — 14 day, dose 4MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: FairMedDRA releases: 2024-11 · check-in answers available
-
2022-12-24
Health check-in — 21 day, dose 4Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitAdult check-in
- 2022-12-24
- 2022-12-28
- 2022-12-29
- 2023-01-05
- 2023-01-12
- 2023-06-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-28 | Pfizer-BioNTech | |
| 2 | 2021-03-21 | Pfizer-BioNTech | |
| 3 | 2021-12-27 | Moderna | No |
| 4 | 2022-12-01 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-07 | Successful 2022-02-09 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-12-24 | Unsuccessful |
Free text
Release 10
Systemic reaction (other): Swollen lymph nodes in armpit on injection arm
Release 11
Symptoms: Unrelated to vaccine. Adverse reaction to hysteroscopy. Polyp was removed, but caused excessive bleeding 5 days after procedure. Lost a lot of blood; needed emergency D&C to remove other polyps & stop bleeding. Now dealing with anemia & tachycardia. cut off by CDC
Release 12
Systemic reaction (other): Swollen, tender lymph nodes
Systemic reaction (other): Swollen lymph node in base of neck above collarbone
Symptoms: Mild sore throat & slight congestion
Symptoms: Cold like symptoms plus a small kidney stone
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 | Oropharyngeal pain | · | · | ✓ |
| SD | Procedural complication | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release