Y45-27840-40243
4 vaccinations
1 coded response
25 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 610 / IL
- Registered
- 2020-12-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-17
Dose 1 — Pfizer-BioNTech
-
2020-12-18
Registered in v-safe
- 2020-12-18
- 2020-12-19
- 2020-12-20
- 2020-12-21
- 2020-12-22
- 2020-12-26
- 2021-01-02
-
2021-01-06
Dose 2 — Pfizer-BioNTech
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-13
- 2021-01-20
- 2021-01-27
- 2021-02-03
- 2021-02-10
- 2021-02-17
- 2021-04-07
- 2021-07-07
-
2021-10-13
Dose 3 — Pfizer-BioNTech
- 2022-01-06
-
2022-04-27
Dose 4 — Moderna
- 2022-07-27
-
2022-10-26
Survey response — 6 months, dose 4MedDRA: COVID-19, Mental disorder — 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 professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: I had Covid and a nervous system breakdown from it.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-26
Report sent to call center — 6 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2022-10-27
-
2022-11-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-04-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-17 | Pfizer-BioNTech | |
| 2 | 2021-01-06 | Pfizer-BioNTech | |
| 3 | 2021-10-13 | Pfizer-BioNTech | No |
| 4 | 2022-04-27 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-26 | Successful 2022-11-01 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — 6 months, dose 4
Symptoms: I had Covid and a nervous system breakdown from it.
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 | COVID-19 | · | · | ✓ |
| SD | Mental disorder | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release