X6Y-84930-08738
2 vaccinations
4 coded responses
17 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 434 / OH
- Registered
- 2021-04-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-16
Registered in v-safe
-
2021-04-16
Dose 1 — Pfizer-BioNTech
-
2021-04-16
Health check-in — day 0, dose 1Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body achesAdult check-in
- 2021-04-17
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-30
-
2021-05-06
Dose 2 — Pfizer-BioNTech
-
2021-05-14
Survey response — day 7, dose 2MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Redness, Swelling, ItchingFree text: Severe lymph node swelling in armpitsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-20
-
2021-05-27
Survey response — day 21, dose 2MedDRA: Nodule, Oedema peripheral — Feeling: GoodFree text: The swelling in my arm wont go awayI had a huge reaction(size of softbal) and it just wont flatten out and go away.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-03
-
2021-06-12
Survey response — day 35, dose 2MedDRA: Abdominal pain upper, Chills, Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Chills belly ache cold symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-17
- 2021-08-05
- 2021-11-04
-
2022-05-06
Survey response — 12 months, dose 2MedDRA: Acute kidney injury — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Kidney Failure acuteMedDRA releases: 2024-11 · check-in free text available
-
2022-05-06
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-05-09
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-16 | Pfizer-BioNTech | |
| 2 | 2021-05-06 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-06 | Successful 2022-05-09 |
Not applicable - Accidental Reporting |
Free text
Release 8 — day 7, dose 2
Systemic reaction (other): Severe lymph node swelling in armpits
Release 8 — day 21, dose 2
Symptoms: The swelling in my arm wont go awayI had a huge reaction(size of softbal) and it just wont flatten out and go away.
Release 9 — day 35, dose 2
Symptoms: Chills belly ache cold symptoms
Release 11 — 12 months, dose 2
Symptoms: Kidney Failure acute
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 pain upper | ✓ | ✓ | ✓ |
| SD | Acute kidney injury | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Nodule | ✓ | ✓ | ✓ |
| SD | Oedema peripheral | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release