YX9-17877-28047
4 vaccinations
4 coded responses
25 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 031 / NH
- Registered
- 2021-04-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-25
Dose 1 — Pfizer-BioNTech
-
2021-04-15
Dose 2 — Pfizer-BioNTech
-
2021-04-18
Registered in v-safe
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-07-15
- 2021-10-14
-
2021-10-23
Dose 3 — Pfizer-BioNTech
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2022-01-22
-
2022-04-14
Dose 4 — Pfizer-BioNTech
-
2022-04-19
Survey response — days 1–6 daily, dose 4MedDRA: Chills, Headache, Myalgia, Pyrexia — Feeling: GoodFree text: The day I rec'd the vaccine I had fever, chills, muscle aches, and headache which lasted for 1.5 daysMedDRA releases: 2024-11 · check-in free text available
- 2022-04-20
- 2022-04-21
- 2022-04-28
- 2022-05-05
-
2022-05-12
Survey response — day 28, dose 4MedDRA: Dyspnoea, Fatigue — Feeling: FairFree text: Fatigue, shortness of breathMedDRA releases: 2024-11 · check-in free text available
- 2022-05-19
-
2022-05-26
Survey response — day 42, dose 4MedDRA: COVID-19, Cough, Oropharyngeal pain, Rhinorrhoea — Feeling: Good · 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 visitFree text: Covid - sore throat, runny nose, coughMedDRA releases: 2024-11 · check-in free text available
-
2022-05-26
Report sent to call center — day 42, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-05-27
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-07-14
Survey response — 3 months, dose 4MedDRA: COVID-19, Electrocardiogram abnormal, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: Despite 4 vaccine doses I got covid on 5/22. Ecg showed one month later shiwed tachycardia and inferior infarction, old. Now scheduling cardiac testing · Healthcare visit (other): PCP visit eith teferral to cardiologist scheduled. Will have cardiac stress test and echocardiogram scheduledMedDRA releases: 2024-11 · check-in free text available
-
2022-07-14
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-07-15
Call successfulParticipant prefers to complete VAERS report online
- 2023-04-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-25 | Pfizer-BioNTech | |
| 2 | 2021-04-15 | Pfizer-BioNTech | |
| 3 | 2021-10-23 | Pfizer-BioNTech | No |
| 4 | 2022-04-14 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-26 | Successful 2022-05-27 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-07-14 | Successful 2022-07-15 |
Participant prefers to complete VAERS report online |
Free text
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): The day I rec'd the vaccine I had fever, chills, muscle aches, and headache which lasted for 1.5 days
Release 11 — day 28, dose 4
Symptoms: Fatigue, shortness of breath
Release 11 — day 42, dose 4
Symptoms: Covid - sore throat, runny nose, cough
Release 12 — 3 months, dose 4
Symptoms: Despite 4 vaccine doses I got covid on 5/22. Ecg showed one month later shiwed tachycardia and inferior infarction, old. Now scheduling cardiac testing
Healthcare visit (other): PCP visit eith teferral to cardiologist scheduled. Will have cardiac stress test and echocardiogram scheduled
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 | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Electrocardiogram abnormal | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release