Y8W-61566-66997
4 vaccinations
5 coded responses
38 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 502 / IA
- Registered
- 2021-01-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
JBF-21019-59854
Child or adolescent in my care · Male · 2022-07-06
Timeline
-
2021-01-05
Registered in v-safe
-
2021-01-05
Dose 1 — Pfizer-BioNTech
-
2021-01-05
Survey response — day 0, dose 1MedDRA: Dizziness — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: LightheadedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-19
-
2021-01-26
Dose 2 — Pfizer-BioNTech
-
2021-01-26
Survey response — day 0, dose 2MedDRA: Dizziness — Feeling: Good · Site: PainFree text: LightheadednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
-
2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-04-27
- 2021-07-27
-
2021-10-12
Dose 3 — Pfizer-BioNTechCo-administered: Flu
-
2022-01-26
Survey response — 12 months, dose 2MedDRA: Pharyngitis streptococcal — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Strep throatMedDRA releases: 2024-11 · check-in free text available
-
2022-01-26
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-01-31
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-10-12
Survey response — 12 months, dose 3MedDRA: Ageusia, Anosmia, Cough, Dyspnoea, Fatigue, Headache, Pregnancy, Pyrexia, SARS-CoV-2 test positive — 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 · Telehealth, virtual health, or email health consultationFree text: Pregnancy, positive Covid 19 test with the following symptoms: shortness of breath, fatigue, fever, cough, headache, loss of taste and smellMedDRA releases: 2024-11 · check-in free text available
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2022-10-12
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-10-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-11-04
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-11-06
- 2022-11-07
- 2022-11-08
- 2022-11-09
- 2022-11-10
- 2022-11-11
- 2022-11-18
- 2022-12-02
- 2022-12-09
-
2022-12-16
Survey response — day 42, dose 4MedDRA: Cough, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Cough and feverMedDRA releases: 2024-11 · check-in free text available
- 2023-02-03
- 2023-05-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Pfizer-BioNTech | |
| 2 | 2021-01-26 | Pfizer-BioNTech | |
| 3 | 2021-10-12 | Pfizer-BioNTech | Flu |
| 4 | 2022-11-04 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-26 | Successful 2022-01-31 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-10-12 | Successful 2022-10-13 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 1 — day 0, dose 1
Systemic reaction (other): Lightheaded
Release 2 — day 0, dose 2
Systemic reaction (other): Lightheadedness
Release 11 — 12 months, dose 2
Symptoms: Strep throat
Release 12 — 12 months, dose 3
Symptoms: Pregnancy, positive Covid 19 test with the following symptoms: shortness of breath, fatigue, fever, cough, headache, loss of taste and smell
Release 12 — day 42, dose 4
Symptoms: Cough and fever
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 | Ageusia | · | · | ✓ |
| SD | Anosmia | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Pharyngitis streptococcal | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release