Z3V-30816-57267
5 vaccinations
7 coded responses
45 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 606 / IL
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-31
Registered in v-safe
-
2021-03-31
Dose 1 — Pfizer-BioNTech
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2021-04-01
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-04-02
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Itching · Fatigue or tiredness, NauseaAdult check-in
- 2021-04-03
- 2021-04-05
- 2021-04-07
- 2021-04-14
-
2021-04-21
Dose 2 — Pfizer-BioNTech
-
2021-04-21
Survey response — day 0, dose 2MedDRA: Ear discomfort — Feeling: Good · Fatigue or tirednessFree text: Itchy earsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-22
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-04-25
- 2021-04-26
- 2021-04-27
- 2021-04-28
-
2021-05-05
Survey response — day 14, dose 2MedDRA: Haematochezia — Feeling: GoodFree text: Blood in stool.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-07-21
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2021-10-20
Survey response — 6 months, dose 2MedDRA: Cyanosis, Depression, Dyspnoea, Fatigue, Myalgia, Thyroid mass — 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 · Outpatient clinic or urgent care clinic visitFree text: Fatigue, shorter of breath, muscle soreness, have been diagnosed with depression, am waiting on thyroid tests, have a thyroid nodule, cyanosis of neck.MedDRA releases: 2024-11 · check-in free text available
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2021-10-20
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-22
-
2021-11-29
Dose 3 — Pfizer-BioNTech
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2022-04-21
Survey response — 12 months, dose 2MedDRA: Bradykinesia, Colour blindness, Diplopia, Dizziness, Dyskinesia, Emotional poverty, Fatigue, Gait disturbance, Headache, Holmes-Adie pupil, Neck pain, Paraesthesia, Photopsia — 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 consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Dizziness, tingling on right side, rt side involuntary movement, adies tonic pupil, extreme fatigue, intermittent colorblindness, dark eye flashes, double vision, headaches, neck ache (sometimes rt side only), loss of emotions, slow and jerky walkingMedDRA releases: 2024-11 · check-in free text available
-
2022-04-21
Report sent to call center — 12 months, dose 2Be 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 · 1 call case(s)
- 2022-04-22
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2022-04-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-08-06
Dose 4 — Pfizer-BioNTech
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2022-08-08
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2022-08-09
-
2022-08-10
Survey response — days 1–6 daily, dose 4MedDRA: Lymphadenopathy — Feeling: GoodFree text: Swollen armpit lynph node since sunday. I got the shpt on that side.MedDRA releases: 2024-11 · check-in free text available
- 2022-08-11
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2022-08-12
Survey response — days 1–6 daily, dose 4MedDRA: Rectal haemorrhage — Feeling: Good · DiarrheaFree text: Rectal bleedingMedDRA releases: 2024-11 · check-in free text available
- 2022-08-13
- 2022-08-20
- 2022-08-27
- 2022-09-03
- 2022-09-10
- 2022-09-17
-
2022-10-24
Dose 5 — Pfizer-BioNTechCo-administered: Flu
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2022-10-25
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2022-10-26
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
- 2022-10-27
- 2022-10-28
- 2022-10-29
- 2022-10-30
- 2022-10-31
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2022-11-07
Survey response — day 14, dose 5MedDRA: Rectal haemorrhage — Feeling: GoodFree text: Rectal bleeding.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-14
- 2022-11-21
- 2022-11-28
- 2022-12-05
- 2023-01-23
- 2023-04-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Pfizer-BioNTech | |
| 2 | 2021-04-21 | Pfizer-BioNTech | |
| 3 | 2021-11-29 | Pfizer-BioNTech | No |
| 4 | 2022-08-06 | Pfizer-BioNTech | No |
| 5 | 2022-10-24 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-10-20 | Successful | Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-04-21 | Successful 2022-04-25 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 7 — day 0, dose 2
Systemic reaction (other): Itchy ears
Release 8 — day 14, dose 2
Symptoms: Blood in stool.
Release 10 — 6 months, dose 2
Symptoms: Fatigue, shorter of breath, muscle soreness, have been diagnosed with depression, am waiting on thyroid tests, have a thyroid nodule, cyanosis of neck.
Release 11 — 12 months, dose 2
Symptoms: Dizziness, tingling on right side, rt side involuntary movement, adies tonic pupil, extreme fatigue, intermittent colorblindness, dark eye flashes, double vision, headaches, neck ache (sometimes rt side only), loss of emotions, slow and jerky walking cut off by CDC
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Swollen armpit lynph node since sunday. I got the shpt on that side.
Systemic reaction (other): Rectal bleeding
Release 12 — day 14, dose 5
Symptoms: Rectal bleeding.
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 | Bradykinesia | · | · | ✓ |
| SD | Colour blindness | · | · | ✓ |
| SD | Cyanosis | · | · | ✓ |
| SD | Depression | · | · | ✓ |
| SD | Diplopia | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Dyskinesia | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Emotional poverty | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Gait disturbance | · | · | ✓ |
| SD | Haematochezia | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Holmes-Adie pupil | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Paraesthesia | · | · | ✓ |
| SD | Photopsia | · | · | ✓ |
| SD | Rectal haemorrhage | · | · | ✓ |
| SD | Thyroid mass | · | · | ✓ |
| SRO | Ear discomfort | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Rectal haemorrhage | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release