Z6Q-31015-03493
3 vaccinations
1 coded response
20 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 535 / WI
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-29
Dose 1 — Janssen/Johnson & Johnson
-
2021-03-31
Registered in v-safe
-
2021-03-31
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-10-01
-
2021-10-25
Dose 2 — Pfizer-BioNTech
- 2022-03-29
-
2022-09-10
Dose 3 — Pfizer-BioNTechCo-administered: Flu
- 2022-09-25
- 2022-10-02
- 2022-10-08
- 2022-10-15
-
2022-10-22
Survey response — day 42, dose 3MedDRA: Abdominal pain upper, Ulcer — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Upper left quadrant abdominal pain. Suspected ulcer. Waiting to see a specialist for confirmation.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-22
Report sent to call center — day 42, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2022-10-25
Call successfulDoes not wish to fill out VAERS report
- 2022-12-10
- 2023-03-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-29 | Janssen/Johnson & Johnson | |
| 2 | 2021-10-25 | Pfizer-BioNTech | No |
| 3 | 2022-09-10 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-22 | Successful 2022-10-25 |
Does not wish to fill out VAERS report |
Free text
Release 12 — day 42, dose 3
Symptoms: Upper left quadrant abdominal pain. Suspected ulcer. Waiting to see a specialist for confirmation.
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 | Abdominal pain upper | · | · | ✓ |
| SD | Ulcer | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release