Y4W-13535-66365
4 vaccinations
6 coded responses
41 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 191 / PA
- Registered
- 2021-03-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-06
Registered in v-safe
-
2021-03-06
Dose 1 — Pfizer-BioNTech
- 2021-03-06
-
2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Injection site sore but improvingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-20
-
2021-03-27
Dose 2 — Pfizer-BioNTech
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-10
-
2021-04-17
Survey response — day 21, dose 2MedDRA: Decreased appetite, Diarrhoea, Fatigue — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Extreme fatigue & bout of diarrhea which lasted 2 daysAppetite dwindling over past 3 daysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-24
- 2021-05-01
- 2021-05-08
- 2021-06-26
- 2021-09-25
-
2021-10-28
Dose 3 — Pfizer-BioNTech
- 2022-03-27
-
2022-04-28
Dose 4 — Moderna
- 2022-04-28
-
2022-04-29
Survey response — days 1–6 daily, dose 4MedDRA: Abdominal pain upper — Feeling: Good · Site: PainFree text: Stomachache last night but went awayMedDRA releases: 2024-11 · check-in free text available
- 2022-04-30
- 2022-05-01
- 2022-05-02
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-12
- 2022-05-19
- 2022-05-26
- 2022-06-02
- 2022-06-09
-
2022-07-28
Survey response — 3 months, dose 4MedDRA: Condition aggravated, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: My hydradenitis supportiva which was dormant for many years returned & family Dr said it could be related to vaccine; however, after a few flare ups they're in remission again.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-28
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-07-29
-
2022-07-29
Call successfulOther
-
2022-10-27
Survey response — 6 months, dose 4MedDRA: Pre-existing disease — Feeling: GoodFree text: Hyadenitis supportiva resurfaced after almost 20 years in remission. Being treated topicallyMedDRA releases: 2024-11 · check-in free text available
-
2023-04-28
Survey response — 12 months, dose 4MedDRA: Condition aggravated, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-04-28
Report sent to call center — 12 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
-
2023-05-01
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-06 | Pfizer-BioNTech | |
| 2 | 2021-03-27 | Pfizer-BioNTech | |
| 3 | 2021-10-28 | Pfizer-BioNTech | No |
| 4 | 2022-04-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-07-28 | Successful 2022-07-29 |
Other |
| 2023-04-28 | Successful 2023-05-01 |
Participant prefers to complete VAERS report online |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Injection site sore but improving
Release 7 — day 21, dose 2
Symptoms: Extreme fatigue & bout of diarrhea which lasted 2 daysAppetite dwindling over past 3 days
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Stomachache last night but went away
Release 12 — 3 months, dose 4
Symptoms: My hydradenitis supportiva which was dormant for many years returned & family Dr said it could be related to vaccine; however, after a few flare ups they're in remission again.
Release 12 — 6 months, dose 4
Symptoms: Hyadenitis supportiva resurfaced after almost 20 years in remission. Being treated topically
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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| HCVO | Pre-existing disease | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Decreased appetite | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Abdominal pain upper | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release