YZX-16905-07621
4 vaccinations
4 coded responses
15 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 554 / MN
- Registered
- 2021-05-27
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- N/A
Timeline
-
2021-05-06
Dose 1 — Pfizer-BioNTech
-
2021-05-27
Registered in v-safe
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2021-05-27
Dose 2 — Pfizer-BioNTech
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2021-05-27
Health check-in — day 0, dose 2Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-05-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-05-30
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness, Abdominal painAdult check-in
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2021-05-31
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
- 2021-06-02
- 2021-06-03
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2021-06-10
Survey response — day 14, dose 2MedDRA: Faecaloma, Fatigue, Headache — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: Headaches, fatigue has increased, and impacted bowels.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-17
Survey response — day 21, dose 2MedDRA: Fatigue, Myalgia, Pre-existing disease — 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 · Emergency room or emergency department visitFree text: I had about with diverticulitis and unspecified muscle pain. But contributing to fatigue.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-17
Report sent to call center — day 21, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-06-24
- 2021-06-25
-
2021-06-28
Call successfulParticipant prefers to complete VAERS report online
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2021-08-28
Survey response — 3 months, dose 2MedDRA: Hospitalisation, Oesophagogastroduodenoscopy abnormal, Soft tissue excision — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Since the last check in I was hospitalized a second time. I then had a follow up procedure (EGD) 2 weeks ago, where they removed polio and inflamed tissue from the stomach. I have not had a follow up with my physicians go over the pathology report.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-09-14
Dose 3 — Pfizer-BioNTech
- 2021-11-25
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2022-04-26
Dose 4 — Moderna
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2022-05-03
Health check-in — day 7, dose 4Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2022-05-24
Survey response — day 28, dose 4MedDRA: Chills, Cough, Pain, Pyrexia, Upper respiratory tract congestion — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: On May 2 eyes experienced a fever of one 04. 8°F which I struggled to lower for two days. Besides the fever I had chills bodyaches which started to relieve itself and moved into an upper respiratory cough and congestion which persisted until the 21sMedDRA releases: 2024-11 · check-in free text available
- 2022-05-31
- 2022-06-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-06 | Pfizer-BioNTech | |
| 2 | 2021-05-27 | Pfizer-BioNTech | |
| 3 | 2021-09-14 | Pfizer-BioNTech | No |
| 4 | 2022-04-26 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-06-17 | Successful 2021-06-28 |
Participant prefers to complete VAERS report online |
Free text
Release 9 — day 14, dose 2
Symptoms: Headaches, fatigue has increased, and impacted bowels.
Release 9 — day 21, dose 2
Symptoms: I had about with diverticulitis and unspecified muscle pain. But contributing to fatigue.
Release 9 — 3 months, dose 2
Symptoms: Since the last check in I was hospitalized a second time. I then had a follow up procedure (EGD) 2 weeks ago, where they removed polio and inflamed tissue from the stomach. I have not had a follow up with my physicians go over the pathology report. cut off by CDC
Release 11 — day 28, dose 4
Symptoms: On May 2 eyes experienced a fever of one 04. 8°F which I struggled to lower for two days. Besides the fever I had chills bodyaches which started to relieve itself and moved into an upper respiratory cough and congestion which persisted until the 21s cut off by CDC
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 | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Faecaloma | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | · | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Oesophagogastroduodenoscopy abnormal | ✓ | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Soft tissue excision | ✓ | · | ✓ |
| SD | Upper respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release