Z96-12812-35573
4 vaccinations
11 coded responses
47 check-ins
10 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 780 / TX
- Registered
- 2021-02-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-08
Dose 1 — Pfizer-BioNTech
-
2021-02-09
Registered in v-safe
-
2021-02-09
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Fatigue or tirednessFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
-
2021-02-11
Survey response — days 1–6 daily, dose 1MedDRA: Therapeutic response unexpected — Feeling: GoodFree text: Unexplained disappearance of what I thought was prolonged seasonal sinusitis...going on since late summer, & I had not yet started an antibiotic that my internist had prescribed on Feb 5. I felt I wanted to wait to start it at least 48 hours after the 1st shot in case I had any reaction to the vaccine , which I have not . Now I do not plan to take the med and will notify my physician tomorrow .MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-22
-
2021-03-01
Dose 2 — Pfizer-BioNTech
- 2021-03-01
- 2021-03-02
-
2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: Night sweats — Feeling: GoodFree text: Night sweatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-03-29
- 2021-04-05
-
2021-04-12
Survey response — day 42, dose 2MedDRA: Musculoskeletal discomfort — Feeling: GoodFree text: Mild back/ neck discomfort after daily activities . Has not required seeking care or regular pain meds of any kind.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-31
-
2021-08-30
Survey response — 6 months, dose 2MedDRA: Abdominal pain upper, Office visit, Tenderness — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Several recent days of lateral epigastric dull cramping/ tenderness. · Healthcare visit (other): Physician office visitMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-30
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-03
-
2021-09-24
Dose 3 — Pfizer-BioNTech
-
2021-10-01
Survey response — day 7, dose 3MedDRA: No adverse event — Feeling: GoodFree text: NoneMedDRA releases: 2024-11 · check-in free text available
- 2021-10-08
-
2021-10-15
Survey response — day 21, dose 3MedDRA: Arthralgia, Headache, Neck pain, Self-medication — Feeling: GoodFree text: Within past 24 hrs - neck/ shoulder aching ( no known cause)& mild, nagging headache. All responded to local muscle ointments and heat. No oral meds needed.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-22
- 2021-10-29
- 2021-11-05
-
2021-12-24
Survey response — 3 months, dose 3MedDRA: Body temperature increased, Influenza virus test negative, Office visit, Respiratory tract congestion, SARS-CoV-2 test negative, Sinus congestion, Upper respiratory tract congestion — 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: Upper respiratory mild sinus/ upper chest congestion ; mild temp( 99.9) x3 days ; negative testing at urgent care for flu/ covidMedDRA releases: 2024-11 · check-in free text available
-
2021-12-24
Report sent to call center — 3 months, dose 3Get 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)
-
2021-12-27
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-03-25
-
2022-04-29
Dose 4 — Pfizer-BioNTech
- 2022-04-29
- 2022-04-30
- 2022-05-01
-
2022-05-02
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-13
- 2022-05-20
-
2022-05-29
Survey response — day 28, dose 4MedDRA: Office visit, Pain in extremity, Thrombosis, Ultrasound scan abnormal, X-ray limb abnormal — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Mild pain on lateral right lower leg ; ultrasound/ plain X-rays revealed blood clot in muscle treating conservatively for comfort . No history of recent trauma to the area . · Healthcare visit (other): Dr's office in personMedDRA releases: 2024-11 · check-in free text available
-
2022-05-29
Report sent to call center — day 28, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-06-01
- 2022-06-01
- 2022-06-01
- 2022-06-03
- 2022-06-10
- 2022-07-29
- 2022-10-28
-
2023-04-29
Survey response — 12 months, dose 4MedDRA: No adverse event — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-08 | Pfizer-BioNTech | |
| 2 | 2021-03-01 | Pfizer-BioNTech | |
| 3 | 2021-09-24 | Pfizer-BioNTech | No |
| 4 | 2022-04-29 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-08-30 | Successful | Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2021-12-24 | Successful 2021-12-27 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-05-29 | Unsuccessful |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): No
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Unexplained disappearance of what I thought was prolonged seasonal sinusitis...going on since late summer, & I had not yet started an antibiotic that my internist had prescribed on Feb 5. I felt I wanted to wait to start it at least 48 hours after the 1st shot in case I had any reaction to the vaccine , which I have not . Now I do not plan to take the med and will notify my physician tomorrow .
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Night sweat
Release 7 — day 42, dose 2
Symptoms: Mild back/ neck discomfort after daily activities . Has not required seeking care or regular pain meds of any kind.
Release 9 — 6 months, dose 2
Symptoms: Several recent days of lateral epigastric dull cramping/ tenderness.
Healthcare visit (other): Physician office visit
Release 9 — day 7, dose 3
Systemic reaction (other): None
Release 10 — day 21, dose 3
Symptoms: Within past 24 hrs - neck/ shoulder aching ( no known cause)& mild, nagging headache. All responded to local muscle ointments and heat. No oral meds needed.
Release 10 — 3 months, dose 3
Symptoms: Upper respiratory mild sinus/ upper chest congestion ; mild temp( 99.9) x3 days ; negative testing at urgent care for flu/ covid
Release 11 — days 1–6 daily, dose 4
Release 11 — day 28, dose 4
Symptoms: Mild pain on lateral right lower leg ; ultrasound/ plain X-rays revealed blood clot in muscle treating conservatively for comfort . No history of recent trauma to the area .
Healthcare visit (other): Dr's office in person
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 | Body temperature increased | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Influenza virus test negative | · | · | ✓ |
| SD | Musculoskeletal discomfort | ✓ | ✓ | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | No adverse event | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Tenderness | ✓ | · | ✓ |
| SD | Thrombosis | · | · | ✓ |
| SD | Ultrasound scan abnormal | · | · | ✓ |
| SD | Upper respiratory tract congestion | · | · | ✓ |
| SD | X-ray limb abnormal | · | · | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Therapeutic response unexpected | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release