X6Z-25176-06408
2 vaccinations
3 coded responses
23 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 211 / MD
- Registered
- 2021-09-13
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
-
2021-09-13
Registered in v-safe
-
2021-09-13
Dose 1 — Pfizer-BioNTech
-
2021-09-13
Survey response — day 0, dose 1MedDRA: Guillain-Barre syndrome — Feeling: GoodFree text: Have Guillian-Barre SyndromeMedDRA releases: 2024-11 · check-in free text available
- 2021-09-14
- 2021-09-15
- 2021-09-16
-
2021-09-17
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: Fair · Diarrhea, Abdominal painFree text: Menstruation likely cause of these symptomsMedDRA releases: 2024-11 · check-in free text available
- 2021-09-19
- 2021-09-20
- 2021-09-27
-
2021-10-04
Dose 2 — Pfizer-BioNTech
- 2021-10-04
-
2021-10-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
- 2021-10-06
- 2021-10-07
- 2021-10-09
- 2021-10-10
- 2021-10-11
- 2021-10-18
- 2021-10-25
- 2021-11-01
- 2021-11-08
- 2021-11-15
-
2022-01-03
Survey response — 3 months, dose 2MedDRA: Migraine, Pyrexia — 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 consultationFree text: Migraines, sometimes running feverMedDRA releases: 2024-11 · check-in free text available
-
2022-01-03
Report sent to call center — 3 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 · 1 call case(s)
-
2022-01-07
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-06
- 2022-10-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-09-13 | Pfizer-BioNTech | No |
| 2 | 2021-10-04 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-03 | Successful 2022-01-07 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 9 — day 0, dose 1
Systemic reaction (other): Have Guillian-Barre Syndrome
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Menstruation likely cause of these symptoms
Release 10 — 3 months, dose 2
Symptoms: Migraines, sometimes running fever
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 | Migraine | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Guillain-Barre syndrome | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release