Y56-12122-30046
2 vaccinations
7 coded responses
24 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 933 / CA
- Registered
- 2021-03-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-19
Registered in v-safe
-
2021-03-19
Dose 1 — Pfizer-BioNTech
- 2021-03-19
- 2021-03-20
-
2021-03-21
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease — Feeling: GoodFree text: If helpful I have afib with glitter and no problemsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
-
2021-03-23
Survey response — days 1–6 daily, dose 1MedDRA: Atrial fibrillation — Feeling: GoodFree text: Previously reported I have afib with flutter and no symptoms with shot have next shot april 9MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-04-02
-
2021-04-09
Dose 2 — Pfizer-BioNTech
- 2021-04-10
-
2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Hypertension, Office visit — Feeling: GoodFree text: Blood pressure high- saw cardiologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Hypertension — Feeling: GoodFree text: I reported high blood pressure yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-23
- 2021-04-30
-
2021-05-07
Survey response — day 28, dose 2MedDRA: Hypotension — Feeling: GoodFree text: The bottom number on blood pressure continues to run low- not sure whyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-15
- 2021-05-21
-
2021-07-09
Survey response — 3 months, dose 2MedDRA: Pain in extremity — Feeling: Good · Be unable to do your normal daily activitiesFree text: My feet hurt- podiatrist crated no problem bonesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-10-08
-
2022-04-09
Survey response — 12 months, dose 2MedDRA: Breast mass, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Lump in left breast but won't know for couple weeks if it is cancer · Healthcare visit (other): Mammogram, sonogram. In person and FaceTime appointments, MRI, PET scan stress, BiopsyMedDRA releases: 2024-11 · check-in free text available
-
2022-04-09
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2022-04-11
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-19 | Pfizer-BioNTech | |
| 2 | 2021-04-09 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-09 | Successful 2022-04-11 |
Participant prefers to complete VAERS report online |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): If helpful I have afib with glitter and no problems
Systemic reaction (other): Previously reported I have afib with flutter and no symptoms with shot have next shot april 9
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Blood pressure high- saw cardiologist
Systemic reaction (other): I reported high blood pressure yesterday
Release 8 — day 28, dose 2
Symptoms: The bottom number on blood pressure continues to run low- not sure why
Release 9 — 3 months, dose 2
Symptoms: My feet hurt- podiatrist crated no problem bones
Release 11 — 12 months, dose 2
Symptoms: Lump in left breast but won't know for couple weeks if it is cancer
Healthcare visit (other): Mammogram, sonogram. In person and FaceTime appointments, MRI, PET scan stress, Biopsy
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 | · | · | ✓ |
| SD | Breast mass | · | · | ✓ |
| SD | Hypotension | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Atrial fibrillation | ✓ | ✓ | ✓ |
| SRO | Hypertension | ✓ | ✓ | ✓ |
| SRO | Office visit | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release