XCN-63061-08829
4 vaccinations
7 coded responses
23 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 080 / NJ
- Registered
- 2021-11-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-01
Dose 1 — Pfizer-BioNTech
-
2021-03-23
Dose 2 — Pfizer-BioNTech
-
2021-11-08
Dose 3 — Pfizer-BioNTechCo-administered: Flu
-
2021-11-09
Registered in v-safe
-
2021-11-09
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tiredness, NauseaAdult check-in
-
2021-11-11
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain — Feeling: GoodFree text: Soreness in armpit on same side as injectionMedDRA releases: 2024-11 · check-in free text available
- 2021-11-12
-
2021-11-13
Health check-in — days 1–6 daily, dose 3Feeling: Good · Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-11-14
- 2021-11-15
- 2021-11-22
- 2021-11-29
-
2021-12-06
Survey response — day 28, dose 3MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: PoorFree text: Sore throat, congestionMedDRA releases: 2024-11 · check-in free text available
-
2021-12-13
Survey response — day 35, dose 3MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: FairFree text: Congestion and sore throatMedDRA releases: 2024-11 · check-in free text available
- 2021-12-20
- 2022-02-07
-
2022-05-09
Survey response — 6 months, dose 3MedDRA: Migraine, Nasopharyngitis — Feeling: Good · Be unable to do your normal daily activitiesFree text: I have had several colds and migrainesMedDRA releases: 2024-11 · check-in free text available
-
2022-10-11
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-10-16
- 2022-10-17
- 2022-10-18
- 2022-10-25
-
2022-11-01
Survey response — day 21, dose 4MedDRA: Cough, Oropharyngeal pain, Respiratory tract congestion — Feeling: PoorFree text: Sore throat, cough, mild congestionMedDRA releases: 2024-11 · check-in free text available
-
2022-11-08
Survey response — day 28, dose 4MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Sore throat and congestionMedDRA releases: 2024-11 · check-in free text available
-
2022-11-15
Survey response — day 35, dose 4MedDRA: Hand-foot-and-mouth disease, Peritonsillar abscess — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Hand foot and mouth leading to a paratonsillar abscessMedDRA releases: 2024-11 · check-in free text available
-
2022-11-15
Report sent to call center — day 35, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-11-16
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-11-22
- 2023-01-10
- 2023-04-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-01 | Pfizer-BioNTech | No |
| 2 | 2021-03-23 | Pfizer-BioNTech | No |
| 3 | 2021-11-08 | Pfizer-BioNTech | Flu |
| 4 | 2022-10-11 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-15 | Successful 2022-11-16 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Soreness in armpit on same side as injection
Release 10 — day 28, dose 3
Symptoms: Sore throat, congestion
Release 10 — day 35, dose 3
Symptoms: Congestion and sore throat
Release 11 — 6 months, dose 3
Symptoms: I have had several colds and migraines
Release 12 — day 21, dose 4
Symptoms: Sore throat, cough, mild congestion
Release 12 — day 28, dose 4
Symptoms: Sore throat and congestion
Release 12 — day 35, dose 4
Symptoms: Hand foot and mouth leading to a paratonsillar abscess
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 | Cough | · | · | ✓ |
| SD | Hand-foot-and-mouth disease | · | · | ✓ |
| SD | Migraine | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Peritonsillar abscess | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release