YAD-10072-78111
3 vaccinations
3 coded responses
20 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 981 / WA
- Registered
- 2021-01-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-25
Dose 1 — Pfizer-BioNTech
-
2021-01-27
Registered in v-safe
-
2021-01-27
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal discomfort, Diarrhoea — Feeling: GoodFree text: Little abdominal discomfort Vivid memory of the most severe explosive diarrhea 48 hours after 1st shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-08
- 2021-02-15
-
2021-02-23
Dose 2 — Pfizer-BioNTech
- 2021-02-23
- 2021-02-25
- 2021-02-26
-
2021-03-04
Health check-in — day 7, dose 2Feeling: Fair · Chills, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-10
- 2021-03-18
- 2021-03-23
- 2021-03-31
-
2021-04-08
Survey response — day 42, dose 2MedDRA: Muscle spasms — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Severe cramping of legs (periodic "Charley Horses) Almost immobilizing pain in upper fight leg. Doctor scheduled Physical Therapy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-08
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professionalno matching call case
- 2021-05-28
-
2021-08-24
Dose 3 — Pfizer-BioNTech
- 2021-08-24
- 2022-02-25
-
2022-08-24
Survey response — 12 months, dose 3MedDRA: Fatigue, Living in residential institution, Quarantine, SARS-CoV-2 test positive — Feeling: Fair · 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 consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Symptoms: Tested POSITIVE for Covid On 19 August?.5th day of self quarantine? tested positive again today, 24 August. No runny nose or temp. Having serious FATIGUE! · Healthcare visit (other): Senior Assisted Lining servicesMedDRA releases: 2024-11 · check-in free text available
-
2022-08-24
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 · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-08-25
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Pfizer-BioNTech | |
| 2 | 2021-02-23 | Pfizer-BioNTech | |
| 3 | 2021-08-24 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-08-24 | Successful 2022-08-25 |
Not applicable - Accidental Reporting |
1 report(s) with no call case — see the timeline.
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Little abdominal discomfort Vivid memory of the most severe explosive diarrhea 48 hours after 1st shot
Release 7 — day 42, dose 2
Symptoms: Severe cramping of legs (periodic "Charley Horses) Almost immobilizing pain in upper fight leg. Doctor scheduled Physical Therapy.
Release 12 — 12 months, dose 3
Symptoms: Tested POSITIVE for Covid On 19 August?.5th day of self quarantine? tested positive again today, 24 August. No runny nose or temp. Having serious FATIGUE!
Healthcare visit (other): Senior Assisted Lining services
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 | Living in residential institution | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Muscle spasms | ✓ | ✓ | ✓ |
| SD | Quarantine | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release