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Y4W-26288-75215

3 vaccinations 3 coded responses 13 check-ins 3 free-text entries 2 call cases
Sex
Female
Age at first dose
31-35
ZIP prefix
132 / NY
Registered
2021-10-12
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-16
    Dose 1 — Pfizer-BioNTech
  2. 2021-04-06
    Dose 2 — Pfizer-BioNTech
  3. 2021-10-10
    Dose 3 — Pfizer-BioNTech
  4. 2021-10-12
    Registered in v-safe
  5. 2021-10-12
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  6. 2021-10-13
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site pain — Feeling: Good
    Free text: My arm was sore at the site for the first two days but that was it.
    MedDRA releases: 2024-11 · check-in free text available
  7. 2021-10-14
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  8. 2021-10-15
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  9. 2021-10-16
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  10. 2021-10-17
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  11. 2021-10-24
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  12. 2021-10-31
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  13. 2021-11-07
    Survey response — day 28, dose 3
    MedDRA: Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: I have a possible placental abruption or venous lake
    MedDRA releases: 2024-11 · check-in free text available
  14. 2021-11-07
    Report sent to call center — day 28, dose 3
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · 1 call case(s)
  15. 2021-11-09
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  16. 2021-11-14
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  17. 2021-11-21
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  18. 2022-01-11
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  19. 2022-04-10
    Survey response — 6 months, dose 3
    MedDRA: Caesarean section, Foetal-maternal haemorrhage — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization
    Free text: I had a fetal maternal hemmorhage that resulted in an emergency cesarean at 33 weeks and 4 days
    MedDRA releases: 2024-11 · check-in free text available
  20. 2022-04-10
    Report sent to call center — 6 months, dose 3
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
  21. 2022-04-11
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-03-16Pfizer-BioNTech No
22021-04-06Pfizer-BioNTech No
32021-10-10Pfizer-BioNTech No

Call center

ReportedOutcomeVAERS-related outcome
2021-11-07 Successful
2021-11-09
 Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-10 Successful
2022-04-11
 Participant prefers to complete VAERS report online

Free text

Release 10 — days 1–6 daily, dose 3

2021-10-13

Systemic reaction (other): My arm was sore at the site for the first two days but that was it.

Release 10 — day 28, dose 3

2021-11-07

Symptoms: I have a possible placental abruption or venous lake

Release 11 — 6 months, dose 3

2022-04-10

Symptoms: I had a fetal maternal hemmorhage that resulted in an emergency cesarean at 33 weeks and 4 days

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

FieldPreferred term2021-092023-042024-11
SDCaesarean section · · ✓
SDFoetal-maternal haemorrhage · · ✓
SDUnevaluable event · · ✓
SROInjection site pain · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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