YK3-24172-10926
2 vaccinations
5 coded responses
17 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 913 / CA
- Registered
- 2021-03-18
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-10
Dose 1 — Pfizer-BioNTech
-
2021-03-18
Registered in v-safe
- 2021-03-18
- 2021-03-24
-
2021-03-31
Dose 2 — Pfizer-BioNTech
- 2021-03-31
-
2021-04-01
Survey response — days 1–6 daily, dose 2MedDRA: Dyspnoea — Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Shortness of breath this morning. Ok nowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-02
- 2021-04-03
-
2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Arthritis, Pre-existing disease, Unevaluable event — Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: Arthritis in left hip and legMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: Anaemia, Arthralgia, Arthritis, Back pain, Chronic obstructive pulmonary disease, Dyspnoea, Fatigue, Neuropathy peripheral, Renal disorder — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Kidney disease, severe anemia, COPD, Breast CA survivor, arthritis, neuropathy, tiredness, shortness of breath · Healthcare visit (other): Followup to joint pain in left hip, lower back, fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-05
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-07
Health check-in — day 7, dose 2Feeling: Poor · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-14
-
2021-04-21
Survey response — day 21, dose 2MedDRA: Hospitalisation, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Fainting spells (not new). Currently hospitalized. Non COVID reasonsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-07-01
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2021-09-29
Survey response — 6 months, dose 2MedDRA: Abdominal pain, Anaemia, Intra-abdominal haemorrhage, Medical counselling, Transfusion — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Extreme anemia causing pain and bleeding in abdomen resulting in numerous blood transfusions. Otherwise, healthy, no COVID symptoms. Getting a Pfizer booster shot soon. · Healthcare visit (other): Home health wellness check by a nurse. nurseMedDRA releases: 2024-11 · check-in free text available
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2021-09-29
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-11
-
2021-11-12
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Pfizer-BioNTech | |
| 2 | 2021-03-31 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-05 | Successful | Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-09-29 | Successful 2021-11-12 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Shortness of breath this morning. Ok now
Systemic reaction (other): Arthritis in left hip and leg
Systemic reaction (other): Kidney disease, severe anemia, COPD, Breast CA survivor, arthritis, neuropathy, tiredness, shortness of breath
Healthcare visit (other): Followup to joint pain in left hip, lower back, fatigue
Release 7 — day 21, dose 2
Symptoms: Fainting spells (not new). Currently hospitalized. Non COVID reasons
Release 9 — 6 months, dose 2
Symptoms: Extreme anemia causing pain and bleeding in abdomen resulting in numerous blood transfusions. Otherwise, healthy, no COVID symptoms. Getting a Pfizer booster shot soon.
Healthcare visit (other): Home health wellness check by a nurse. nurse
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 | Arthralgia | ✓ | ✓ | ✓ |
| HCVO | Back pain | ✓ | ✓ | ✓ |
| HCVO | Fatigue | ✓ | ✓ | ✓ |
| HCVO | Medical counselling | · | · | ✓ |
| SD | Abdominal pain | · | · | ✓ |
| SD | Anaemia | · | · | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Intra-abdominal haemorrhage | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Transfusion | · | · | ✓ |
| SRO | Anaemia | ✓ | ✓ | ✓ |
| SRO | Arthritis | ✓ | ✓ | ✓ |
| SRO | Chronic obstructive pulmonary disease | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Neuropathy peripheral | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ○ | ✓ | ○ |
| SRO | Renal disorder | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ○ | ✓ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release