XX9-27574-08655
4 vaccinations
4 coded responses
38 check-ins
4 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 482 / MI
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Registered in v-safe
-
2021-01-12
Dose 1 — Pfizer-BioNTech
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-26
-
2021-02-02
Dose 2 — Pfizer-BioNTech
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-05-04
- 2021-08-03
-
2021-09-16
Dose 3 — Pfizer-BioNTech
- 2021-10-01
- 2021-10-09
- 2021-10-16
- 2021-10-21
- 2021-10-28
-
2021-12-16
Survey response — 3 month, dose 3MedDRA: COVID-19, Chest discomfort, Cough, Dyspnoea, Fatigue, Headache, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11 · check-in answers available
-
2021-12-16
Report sent to call center — 3 month, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2021-12-17
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-03-19
Survey response — 6 month, dose 3MedDRA: Cough, Dyspnoea, Fatigue, Musculoskeletal chest pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11 · check-in answers available
-
2022-03-19
Report sent to call center — 6 month, dose 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-03-24
Call successfulParticipant prefers to complete VAERS report online
-
2022-08-31
Dose 4 — Pfizer-BioNTech
-
2022-09-14
Survey response — 14 day, dose 4MedDRA: Cough, Dyspnoea, Exposure to SARS-CoV-2, Fatigue, Headache, Myalgia, Oropharyngeal pain — Feeling: Poor · 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 visitMedDRA releases: 2024-11 · check-in answers available
-
2022-09-14
Report sent to call center — 14 day, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-09-15
-
2022-09-16
Callback requested for02:00PM ET
-
2022-09-16
Call successfulCompleted over the phone
- 2022-09-21
- 2022-09-28
-
2022-10-05
Survey response — 35 day, dose 4MedDRA: Chest X-ray abnormal, Chest pain, Dyspnoea, Pain, Pneumonitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitMedDRA releases: 2024-11 · check-in answers available
-
2022-10-05
Report sent to call center — 35 day, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
-
2022-10-06
Call successfulReported to VAERS voluntarily prior to GDIT contact
- 2022-10-14
- 2022-11-30
- 2023-03-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Pfizer-BioNTech | |
| 2 | 2021-02-02 | Pfizer-BioNTech | |
| 3 | 2021-09-16 | Pfizer-BioNTech | No |
| 4 | 2022-08-31 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-16 | Successful 2021-12-17 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-03-19 | Successful 2022-03-24 |
Participant prefers to complete VAERS report online |
| 2022-09-14 | Successful 2022-09-16 |
Completed over the phone |
| 2022-10-05 | Successful 2022-10-06 |
Reported to VAERS voluntarily prior to GDIT contact |
Free text
Release 10
Symptoms: Covid positive on 11-4-21 following Pfizer booster on 9-16-21. Cough, SOB with chest tightness, headache and fatique. Received Monoclonal Antibody Infusion 11-5-21 with decreased chest tightness after 48 h. Slowly improving over time
Healthcare visit (other): Follow up CXR and MD visit 12-14-21
Release 11
Symptoms: Cough with shortness of breath and right sided chest wall pain with fatique
Release 12
Symptoms: Exposed to covid 9-10-22 per family members. Currently experiencing SOB, Cough, Sore throat Muscle pain, Headache and fatique.
Symptoms: Sharp pains to right chest with movement and breathing. Increased SOB. No fever. CXRshowing Interstitial Inflammation. CT Scan negative for Pulmonary Emboli. On antibiotic and Prednisone.
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 | Office visit | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | Chest X-ray abnormal | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Musculoskeletal chest pain | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pneumonitis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release