U79-54104-13166
4 vaccinations
9 coded responses
51 check-ins
8 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 601 / IL
- Registered
- 2021-02-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Registered in v-safe
-
2021-02-13
Dose 1 — Pfizer-BioNTech
-
2021-02-13
Survey response — day 0, dose 1MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: dizzyMedDRA 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
- 2021-02-20
-
2021-02-27
Survey response — day 14, dose 1MedDRA: Headache, Lymphadenopathy — Feeling: GoodFree text: glands are sensitive and swollen on Friday, but fine nowheadaches on and off on Wednesday, but fine nowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-06
Dose 2 — Pfizer-BioNTech
- 2021-03-06
-
2021-03-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-08
-
2021-03-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-03-10
Survey response — days 1–6 daily, dose 2MedDRA: Ear pain, Rash — Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: rash on both legs, ear painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-10
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationAdult check-in
-
2021-03-11
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-03-13
Health check-in — day 7, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-20
- 2021-03-28
- 2021-04-03
- 2021-04-10
-
2021-04-17
Survey response — day 42, dose 2MedDRA: Plantar fasciitis — Feeling: Good · Be unable to do your normal daily activitiesFree text: plantar fasciitis in foot on same side as vaccinationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-05
- 2021-09-04
-
2021-10-08
Dose 3 — Pfizer-BioNTech
- 2021-10-08
-
2021-10-09
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body achesAdult check-in
-
2021-10-10
Health check-in — days 1–6 daily, dose 3Feeling: Good · Fever · Muscle or body achesAdult check-in
- 2021-10-11
- 2021-10-12
- 2021-10-13
- 2021-10-14
-
2021-10-15
Health check-in — day 7, dose 3Feeling: Good · Site: Itching · Headache, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-10-22
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-12-15
- 2021-12-20
- 2022-01-07
-
2022-04-08
Survey response — 6 months, dose 3MedDRA: Cough, Diarrhoea, Headache, Middle ear effusion, Oropharyngeal pain, Sinusitis, Vomiting — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: sinus infection, liquid in right ear, headache, sore throat, cough, vomit, diarrheaMedDRA releases: 2024-11 · check-in free text available
-
2022-04-08
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-26
Call successfulNot applicable - Accidental Reporting
-
2022-04-26
Call successfulNot applicable - Accidental Reporting
-
2022-04-26
Call successfulNot applicable - Accidental Reporting
-
2022-09-09
Dose 4 — Moderna
- 2022-09-09
-
2022-09-10
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2022-09-11
- 2022-09-12
- 2022-09-16
- 2022-09-23
-
2022-09-30
Survey response — day 21, dose 4MedDRA: Unevaluable event, Vomiting — Feeling: GoodFree text: temperature, vomitMedDRA releases: 2024-11 · check-in free text available
- 2022-10-07
-
2022-10-14
Survey response — day 35, dose 4MedDRA: Abdominal pain upper, Diarrhoea — Feeling: GoodFree text: stomach cramps, diarrheaMedDRA releases: 2024-11 · check-in free text available
- 2022-10-21
-
2022-12-09
Survey response — 3 months, dose 4MedDRA: Menstruation delayed — Feeling: GoodFree text: period very lateMedDRA releases: 2024-11 · check-in free text available
-
2023-03-10
Survey response — 6 months, dose 4MedDRA: Heavy menstrual bleeding, Menstrual clots, Uterine dilation and curettage — 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 visitMedDRA releases: 2024-11
-
2023-03-10
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)
- 2023-03-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Pfizer-BioNTech | |
| 2 | 2021-03-06 | Pfizer-BioNTech | |
| 3 | 2021-10-08 | Pfizer-BioNTech | No |
| 4 | 2022-09-09 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-10 | Successful 2022-04-26 |
Not applicable - Accidental Reporting |
| 2021-03-11 | Successful 2022-04-26 |
Not applicable - Accidental Reporting |
| 2022-04-08 | Successful 2022-04-26 |
Not applicable - Accidental Reporting |
| 2023-03-10 | Unsuccessful |
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): dizzy
Release 4 — day 14, dose 1
Symptoms: glands are sensitive and swollen on Friday, but fine nowheadaches on and off on Wednesday, but fine now
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): rash on both legs, ear pain
Release 7 — day 42, dose 2
Symptoms: plantar fasciitis in foot on same side as vaccination
Release 11 — 6 months, dose 3
Symptoms: sinus infection, liquid in right ear, headache, sore throat, cough, vomit, diarrhea
Release 12 — day 21, dose 4
Symptoms: temperature, vomit
Release 12 — day 35, dose 4
Symptoms: stomach cramps, diarrhea
Release 12 — 3 months, dose 4
Symptoms: period very late
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 | Uterine dilation and curettage | · | · | ✓ |
| SD | Abdominal pain upper | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Heavy menstrual bleeding | · | · | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Menstrual clots | · | · | ✓ |
| SD | Menstruation delayed | · | · | ✓ |
| SD | Middle ear effusion | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Plantar fasciitis | ✓ | ✓ | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release