XX2-27697-11620
3 vaccinations
5 coded responses
33 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 068 / CT
- Registered
- 2021-05-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-05-01
Dose 1 — Pfizer-BioNTech
-
2021-05-03
Registered in v-safe
- 2021-05-03
- 2021-05-04
- 2021-05-05
- 2021-05-06
- 2021-05-07
- 2021-05-08
- 2021-05-15
- 2021-05-22
-
2021-05-23
Dose 2 — Pfizer-BioNTech
- 2021-05-24
- 2021-05-26
- 2021-05-27
- 2021-05-28
- 2021-05-29
- 2021-05-30
- 2021-06-06
- 2021-06-13
- 2021-06-20
- 2021-06-27
- 2021-07-04
- 2021-08-22
- 2021-11-21
-
2022-01-12
Dose 3 — Moderna
-
2022-01-16
Survey response — days 1–6 daily, dose 3MedDRA: Oral herpes, Pyrexia — Feeling: Fair · Rash, not including the immediate area around the injection siteMedDRA releases: 2024-11 · check-in answers available
-
2022-01-17
Survey response — days 1–6 daily, dose 3MedDRA: Cheilitis, Oral herpes, Self-medication — Feeling: Good · Rash, not including the immediate area around the injection siteMedDRA releases: 2024-11 · check-in answers available
-
2022-01-18
Survey response — days 1–6 daily, dose 3MedDRA: Oral herpes — Feeling: Fair · Headache, Fatigue or tirednessMedDRA releases: 2024-11 · check-in answers available
-
2022-01-19
Survey response — 7 day, dose 3MedDRA: Oral herpes, Self-medication — Feeling: Fair · Fever · Fatigue or tirednessMedDRA releases: 2024-11 · check-in answers available
- 2022-01-26
- 2022-02-02
- 2022-02-09
- 2022-02-16
- 2022-02-23
- 2022-04-13
- 2022-07-13
-
2023-01-13
Survey response — 12 month, dose 3MedDRA: Cough, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Sinus congestion — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11 · check-in answers available
-
2023-01-13
Report sent to call center — 12 month, dose 3Be unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2023-01-16
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-01 | Pfizer-BioNTech | |
| 2 | 2021-05-23 | Pfizer-BioNTech | |
| 3 | 2022-01-12 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-01-13 | Successful 2023-01-16 |
Completed over the phone |
Free text
Release 10
Systemic reaction (other): Cold sores and fever blisters on my lower lips for past 2 days. Worse today than yesterday but no fever. I had a fever 1 day after I got booster shot but it lasted only 24 hours. Fever blisters and cold sores appeared 1 day after fever subsided
Systemic reaction (other): Mild cold sores or fever blisters still visible below lower lip however less irritating than yesterday. Ive been putting Blistex all day yesterday and seems to calm irritation down. However they have not disappeared. Good news is no new cold sores to cut off by CDC
Systemic reaction (other): Fever blisters and cold sores on lower lip still persist but no new ones today
Systemic reaction (other): I still have cold sores and fever blisters on my lower lip but no new ones. They seem to be drying up and getting smaller. I put Blistex on them several times a day for past few days. I might have mild fever. Didnt take my temp.
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 |
|---|---|---|---|---|
| SD | Cough | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SRO | Cheilitis | · | · | ✓ |
| SRO | Oral herpes | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release