Z7Z-64081-27707
1 vaccination
5 coded responses
8 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 850 / AZ
- Registered
- 2021-11-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-18
Dose 1 — Pfizer-BioNTechCo-administered: Tetanus
-
2021-11-19
Registered in v-safe
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2021-11-19
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-11-21
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-11-22
Survey response — days 1–6 daily, dose 1MedDRA: Office visit — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: pcpMedDRA releases: 2024-11 · check-in free text available
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2021-11-22
Report sent to call center — days 1–6 daily, dose 1Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-11-23
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2021-11-23
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2021-11-24
Survey response — days 1–6 daily, dose 1MedDRA: Depression — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: depressionMedDRA releases: 2024-11 · check-in free text available
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2021-11-27
Survey response — day 7, dose 1MedDRA: Mood altered — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: mood changesMedDRA releases: 2024-11 · check-in free text available
- 2021-11-30
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2021-12-02
Survey response — day 14, dose 1MedDRA: Abdominal pain upper, Arthralgia, Back pain, Decreased appetite, Fatigue, Furuncle, Haematuria, Headache, Migraine, Pre-existing disease, Pyrexia, Vaginal haemorrhage — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Stomach pain, boils/bleeding from vaginal area (have partial hysterectomy sept. 17, 2015 1/4 right ovary lef5 in abdomen), fevers 101 -103, severe back pain, shoulder pain wh/ shot given, peeing out blood, migraines& headaches, fatigue, lost hungerMedDRA releases: 2024-11 · check-in free text available
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2022-11-18
Survey response — 12 months, dose 1MedDRA: Back pain, Dehydration, Disturbance in attention, Haematuria, Haemorrhage, Injection site pain, Nephrolithiasis, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: severe pain in my back and dehydration. Kidney stones, trouble concentrating, peeing out blood, focusing, pain in my arm still a year later from the shot injections sight, unexplained bleeding,MedDRA releases: 2024-11 · check-in free text available
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2022-11-18
Report sent to call center — 12 months, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2022-11-21
- 2022-11-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-18 | Pfizer-BioNTech | Tetanus |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-22 | Unsuccessful | |
| 2022-11-18 | Unsuccessful |
Free text
Release 10 — days 1–6 daily, dose 1
Healthcare visit (other): pcp
Systemic reaction (other): depression
Release 10 — day 7, dose 1
Systemic reaction (other): mood changes
Release 10 — day 14, dose 1
Symptoms: Stomach pain, boils/bleeding from vaginal area (have partial hysterectomy sept. 17, 2015 1/4 right ovary lef5 in abdomen), fevers 101 -103, severe back pain, shoulder pain wh/ shot given, peeing out blood, migraines& headaches, fatigue, lost hunger cut off by CDC
Release 12 — 12 months, dose 1
Symptoms: severe pain in my back and dehydration. Kidney stones, trouble concentrating, peeing out blood, focusing, pain in my arm still a year later from the shot injections sight, unexplained 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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Abdominal pain upper | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Decreased appetite | · | · | ✓ |
| SD | Dehydration | · | · | ✓ |
| SD | Disturbance in attention | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Furuncle | · | · | ✓ |
| SD | Haematuria | · | · | ✓ |
| SD | Haemorrhage | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site pain | · | · | ✓ |
| SD | Migraine | · | · | ✓ |
| SD | Nephrolithiasis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Vaginal haemorrhage | · | · | ✓ |
| SRO | Depression | · | · | ✓ |
| SRO | Mood altered | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release