V53-23771-45465
4 vaccinations
4 coded responses
51 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 524 / IA
- Registered
- 2021-04-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-08
Dose 1 — Janssen/Johnson & Johnson
-
2021-04-13
Registered in v-safe
-
2021-04-13
Survey response — days 1–6 daily, dose 1MedDRA: Dry throat, Throat irritation — Feeling: GoodFree text: Dry scratchy throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
- 2021-04-15
- 2021-04-22
-
2021-04-29
Survey response — day 21, single doseMedDRA: Blood urine present — Feeling: FairFree text: Blood in urineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-06
Survey response — day 28, single doseMedDRA: Abdominal tenderness, Blood urine present, Headache — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Blood in urine, abdominal tenderness, persistent headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-06
Report sent to call center — day 28, single doseGet care from a doctor or other healthcare professional1 call case(s)
- 2021-05-13
- 2021-05-20
- 2021-05-28
- 2021-07-08
- 2021-10-07
-
2021-11-05
Dose 2 — Pfizer-BioNTech
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-09
- 2021-11-11
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-10
- 2021-12-17
- 2022-02-04
-
2022-05-03
Dose 3 — Pfizer-BioNTech
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-07
- 2022-05-08
- 2022-05-09
- 2022-05-10
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-06-07
- 2022-06-14
- 2022-08-02
-
2022-10-14
Dose 4 — Pfizer-BioNTech
- 2022-10-15
- 2022-10-16
- 2022-10-17
-
2022-10-18
Survey response — days 1–6 daily, dose 4MedDRA: Feeling cold — Feeling: GoodFree text: Not chills, but back felt like it was laying on cold slab of iceMedDRA releases: 2024-11 · check-in free text available
- 2022-10-19
- 2022-10-20
- 2022-10-21
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-11-18
- 2022-11-25
- 2023-01-13
- 2023-04-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-08 | Janssen/Johnson & Johnson | |
| 2 | 2021-11-05 | Pfizer-BioNTech | No |
| 3 | 2022-05-03 | Pfizer-BioNTech | No |
| 4 | 2022-10-14 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-06 | Unsuccessful |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Dry scratchy throat
Release 8 — day 21, single dose
Symptoms: Blood in urine
Release 8 — day 28, single dose
Symptoms: Blood in urine, abdominal tenderness, persistent headache
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Not chills, but back felt like it was laying on cold slab of ice
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 | Abdominal tenderness | ✓ | ✓ | ✓ |
| SD | Blood urine present | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SRO | Dry throat | ✓ | ✓ | ✓ |
| SRO | Feeling cold | · | · | ✓ |
| SRO | Throat irritation | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release