XW6-30813-33743
4 vaccinations
5 coded responses
49 check-ins
5 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 895 / NV
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 1 — Pfizer-BioNTech
- 2021-01-23
- 2021-01-24
- 2021-01-25
-
2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Oral herpes — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-27
-
2021-01-28
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-01-29
-
2021-01-30
Health check-in — 7 day, dose 1Feeling: Good · Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-06
-
2021-02-13
Dose 2 — Pfizer-BioNTech
- 2021-02-13
-
2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-27
-
2021-03-08
Survey response — 21 day, dose 2MedDRA: Back pain, Incontinence, Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-03-08
Report sent to call center — 21 day, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-05-15
- 2021-08-14
-
2021-09-26
Dose 3 — Pfizer-BioNTech
- 2021-09-29
- 2021-09-30
- 2021-10-01
- 2021-10-02
- 2021-10-03
- 2021-10-10
- 2021-10-17
-
2021-10-31
Survey response — 35 day, dose 3MedDRA: COVID-19, Headache, Nasal congestion, Oropharyngeal pain, Patient isolation — 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 professionalMedDRA releases: 2024-11 · check-in answers available
-
2021-10-31
Report sent to call center — 35 day, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
-
2021-11-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2021-11-07
-
2021-12-26
Survey response — 3 month, dose 3MedDRA: Cough, Influenza, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
-
2022-04-19
Dose 4 — Moderna
-
2022-04-20
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Chills, Fatigue or tirednessAdult check-in
- 2022-04-21
- 2022-04-22
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-05-25
- 2022-06-02
-
2022-07-19
Survey response — 3 month, dose 4MedDRA: Back pain, Office visit, Pain in extremity, Physiotherapy — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2022-07-19
Report sent to call center — 3 month, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-07-20
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-18
- 2023-04-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Pfizer-BioNTech | |
| 2 | 2021-02-13 | Pfizer-BioNTech | |
| 3 | 2021-09-26 | Pfizer-BioNTech | No |
| 4 | 2022-04-19 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-08 | Successful | Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2021-10-31 | Successful 2021-11-02 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-07-19 | Successful 2022-07-20 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 2
Systemic reaction (other): I developed a cold sore.
Release 5
Symptoms: Thought I had a urinary tract infection due to back pain and increased bladder leakage.
Release 10
Symptoms: I have Covid. My symptoms were a stuffy nose, slight headache, and sore throat. I thought it was my allergies
Healthcare visit (other): I'm in isolation in Iceland in Covid Hotel run by the Red Cross
Symptoms: I had influenza A. I had a sore throat and bad cough.
Release 12
Symptoms: Low back pain. Foot pain. Maybe plantar fasciitis
Healthcare visit (other): Doctor visit and physical therapy
Free-text releases are not linked to a specific 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 | COVID-19 | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Patient isolation | · | · | ✓ |
| HCVO | Physiotherapy | · | · | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Incontinence | ✓ | ✓ | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Urinary tract infection | ✓ | ✓ | ✓ |
| SRO | Oral herpes | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release