XYZ-14264-92669
3 vaccinations
9 coded responses
35 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 604 / IL
- Registered
- 2020-12-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Registered in v-safe
-
2020-12-31
Dose 1 — Pfizer-BioNTech
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-05
- 2021-01-06
- 2021-01-07
-
2021-01-14
Survey response — 14 day, dose 1MedDRA: Restless arm syndrome — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-21
-
2021-01-22
Dose 2 — Pfizer-BioNTech
-
2021-01-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, Abdominal painAdult check-in
- 2021-01-24
- 2021-01-26
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-29
Survey response — 7 day, dose 2MedDRA: Visual impairment — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-05
Survey response — 14 day, dose 2MedDRA: Vision blurred — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-13
Survey response — 21 day, dose 2MedDRA: Dizziness, Headache, Oropharyngeal pain — Feeling: FairMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
-
2021-02-19
Survey response — 28 day, dose 2MedDRA: Chills, Headache, Nausea, Pain — Feeling: Fair · Be unable to workMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-26
- 2021-03-07
- 2021-04-23
- 2021-07-23
-
2021-10-01
Dose 3 — Pfizer-BioNTech
-
2021-10-02
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-10-03
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal painMedDRA releases: 2024-11 · check-in answers available
-
2021-10-04
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: PainMedDRA releases: 2024-11 · check-in answers available
-
2021-10-05
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Swelling · HeadacheAdult check-in
-
2021-10-06
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: PainMedDRA releases: 2024-11 · check-in answers available
- 2021-10-08
- 2021-10-15
- 2021-10-24
- 2021-10-31
- 2021-11-07
- 2021-12-31
- 2022-04-01
-
2022-10-01
Survey response — 12 month, dose 3MedDRA: Abortion spontaneous, Hypothyroidism — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11 · check-in answers available
-
2022-10-01
Report sent to call center — 12 month, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-10-03
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-31 | Pfizer-BioNTech | |
| 2 | 2021-01-22 | Pfizer-BioNTech | |
| 3 | 2021-10-01 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-01 | Successful 2022-10-03 |
Not applicable - Accidental Reporting |
Free text
Release 2
Symptoms: Restless arm syndrome on arm that had vaccination that lasted a couple hours 2 nights ago. Not sure if this related.
Release 3
Systemic reaction (other): Pulsating vision
Symptoms: Eye sight is trouble focusing. Zooming in and our when I look at a screen or letters.
Release 4
Symptoms: Sore throat dizziness headache
Symptoms: Headache, nausea, chills, body aches
Release 9
Systemic reaction (other): Swelling in arm pit lymph nodes on arm that had the vaccine
Release 10
Systemic reaction (other): Swelling and pain in armpit where vaccine was given.
Systemic reaction (other): Swelling/tender lymph nodes on neck
Release 12
Symptoms: Hypothyroidism, miscarriages
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 | Abortion spontaneous | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hypothyroidism | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Restless arm syndrome | ✓ | ✓ | ✓ |
| SD | Vision blurred | ✓ | ✓ | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Oedema peripheral | · | · | ✓ |
| SRO | Visual impairment | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release