UT9-22045-81848
4 vaccinations
19 coded responses
52 check-ins
19 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 225 / VA
- Registered
- 2021-06-08
- Relationship
- Self
- Race
- N/A
- Ethnicity
- Hispanic or Latino
Registered dependents
DDN-30677-54100
Child or adolescent in my care · Female · 2021-06-25
7HK-28786-35583
Child or adolescent in my care · Male · 2022-06-20
Timeline
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2021-06-08
Registered in v-safe
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2021-06-08
Dose 1 — Pfizer-BioNTech
- 2021-06-08
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2021-06-09
Survey response — days 1–6 daily, dose 1MedDRA: Eye pain, Hypoaesthesia oral — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Eye pain and lip numbness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-10
Survey response — days 1–6 daily, dose 1MedDRA: Pregnancy — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: Im pregnant 25 weeksMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-11
Survey response — days 1–6 daily, dose 1MedDRA: Constipation, Diarrhoea — Feeling: Good · Site: Pain · DiarrheaFree text: Constipation and diarrea makes no senseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-12
Survey response — days 1–6 daily, dose 1MedDRA: Constipation — Feeling: Good · Headache, Abdominal painFree text: ConstipationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-13
Survey response — days 1–6 daily, dose 1MedDRA: Constipation — Feeling: GoodFree text: Extrémame constipationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-14
Survey response — days 1–6 daily, dose 1MedDRA: Anal inflammation, Anorectal disorder, Constipation — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Extreme constipation and swollen but holeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-14
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-15
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2021-06-17
Call successfulDoes not wish to fill out VAERS report
- 2021-06-22
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2021-06-29
Dose 2 — Pfizer-BioNTech
- 2021-06-29
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2021-06-30
Survey response — days 1–6 daily, dose 2MedDRA: Back pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Excruciating Lower back painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-01
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Constipation, Groin pain — Feeling: Poor · Site: Pain · Muscle or body aches · Be unable to do your normal daily activitiesFree text: Lower back pain, constipation and groin painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-02
Survey response — days 1–6 daily, dose 2MedDRA: Burning sensation, Groin pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Burning groin pain when walking or getting upMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-03
Survey response — days 1–6 daily, dose 2MedDRA: Groin pain, Pain — Feeling: Good · Joint pains · Be unable to do your normal daily activitiesFree text: Groin pain when walking.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-04
Survey response — days 1–6 daily, dose 2MedDRA: Burning sensation, Groin pain, Musculoskeletal discomfort, Thermal burn — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Groin burning painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-05
Survey response — days 1–6 daily, dose 2MedDRA: Dysstasia, Gait disturbance, Groin pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Groin pain that wont let me walk or standMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-06
Survey response — day 7, dose 2MedDRA: Groin pain, Pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Groin pain when walking/standingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-13
- 2021-07-20
- 2021-07-27
- 2021-08-03
- 2021-08-10
- 2021-09-28
- 2021-12-28
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2022-01-11
Dose 3 — ModernaCo-administered: Flu
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2022-01-12
Survey response — days 1–6 daily, dose 3MedDRA: Breast pain — Feeling: Poor · Site: Pain, Swelling · 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 activitiesFree text: Sharp pain like feeling on breasts, I'm lactatingMedDRA releases: 2024-11 · check-in free text available
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2022-01-13
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Abdominal painAdult check-in
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2022-01-14
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Abdominal painAdult check-in
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2022-01-15
Survey response — days 1–6 daily, dose 3MedDRA: Constipation, Reaction to previous exposure to any vaccine — Feeling: Fair · Abdominal painFree text: Constipation, really bad constipation. I had it with both previous shots but blamed it on pregnancy, I'm not pregnant anymore I shouldn't have extreme constipation.MedDRA releases: 2024-11 · check-in free text available
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2022-01-16
Survey response — days 1–6 daily, dose 3MedDRA: Constipation, Headache — Feeling: Good · Headache, Abdominal painFree text: Extreme constipation, sharp pain that comes and goes in the lower left side of my head only.MedDRA releases: 2024-11 · check-in free text available
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2022-01-17
Survey response — days 1–6 daily, dose 3MedDRA: Headache, Pain — Feeling: Good · Site: Redness · HeadacheFree text: Sharp like pains in the right lower side of my head specially when turning my head to the leftMedDRA releases: 2024-11 · check-in free text available
- 2022-01-18
- 2022-01-27
- 2022-02-01
- 2022-02-08
- 2022-02-15
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2022-02-22
Survey response — day 42, dose 3MedDRA: Breast feeding, Lactation insufficiency, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: I had a tremendous dip on my milk supply after the vaccine, I'm now struggling to feed my baby. · Healthcare visit (other): Lactation consultantMedDRA releases: 2024-11 · check-in free text available
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2022-02-22
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-02-23
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-12
- 2022-07-12
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2022-10-15
Dose 4 — Pfizer-BioNTech
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2022-10-16
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-10-17
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-18
- 2022-10-19
- 2022-10-20
- 2022-10-21
- 2022-10-22
- 2022-10-29
- 2022-11-05
- 2022-11-12
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2022-11-19
Survey response — day 35, dose 4MedDRA: Rash, Rash pruritic — Feeling: GoodFree text: bump like insect bites that won't go away and they hurt and itch on back, left arm, breast and chest area.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-26
- 2023-01-14
- 2023-04-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-08 | Pfizer-BioNTech | |
| 2 | 2021-06-29 | Pfizer-BioNTech | No |
| 3 | 2022-01-11 | Moderna | Flu |
| 4 | 2022-10-15 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-14 | Successful 2021-06-17 |
Does not wish to fill out VAERS report |
| 2022-02-22 | Successful 2022-02-23 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Eye pain and lip numbness.
Systemic reaction (other): Im pregnant 25 weeks
Systemic reaction (other): Constipation and diarrea makes no sense
Systemic reaction (other): Constipation
Systemic reaction (other): Extrémame constipation
Systemic reaction (other): Extreme constipation and swollen but hole
Release 9 — days 1–6 daily, dose 2
Systemic reaction (other): Excruciating Lower back pain
Systemic reaction (other): Lower back pain, constipation and groin pain
Systemic reaction (other): Burning groin pain when walking or getting up
Systemic reaction (other): Groin pain when walking.
Systemic reaction (other): Groin burning pain
Systemic reaction (other): Groin pain that wont let me walk or stand
Release 9 — day 7, dose 2
Systemic reaction (other): Groin pain when walking/standing
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sharp pain like feeling on breasts, I'm lactating
Systemic reaction (other): Constipation, really bad constipation. I had it with both previous shots but blamed it on pregnancy, I'm not pregnant anymore I shouldn't have extreme constipation.
Systemic reaction (other): Extreme constipation, sharp pain that comes and goes in the lower left side of my head only.
Systemic reaction (other): Sharp like pains in the right lower side of my head specially when turning my head to the left
Release 11 — day 42, dose 3
Symptoms: I had a tremendous dip on my milk supply after the vaccine, I'm now struggling to feed my baby.
Healthcare visit (other): Lactation consultant
Release 12 — day 35, dose 4
Symptoms: bump like insect bites that won't go away and they hurt and itch on back, left arm, breast and chest area.
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 | Office visit | · | · | ✓ |
| SD | Breast feeding | · | · | ✓ |
| SD | Lactation insufficiency | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rash pruritic | · | · | ✓ |
| SRO | Anal inflammation | ✓ | · | ✓ |
| SRO | Anorectal disorder | ○ | ✓ | ○ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Breast pain | · | · | ✓ |
| SRO | Burning sensation | ✓ | ✓ | ✓ |
| SRO | Constipation | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Dysstasia | ✓ | ✓ | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Gait disturbance | ✓ | ✓ | ✓ |
| SRO | Groin pain | ✓ | ✓ | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Hypoaesthesia oral | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal discomfort | ✓ | ✓ | ○ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pregnancy | ✓ | ✓ | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Thermal burn | ✓ | ✓ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release