Z9E-30966-56142
2 vaccinations
6 coded responses
16 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 314 / GA
- Registered
- 2021-03-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-15
Registered in v-safe
-
2021-03-15
Dose 1 — Pfizer-BioNTech
-
2021-03-15
Survey response — day 0, dose 1MedDRA: Disturbance in attention — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Cant concentrateMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-16
Survey response — days 1–6 daily, dose 1MedDRA: Confusional state, Head discomfort, Pollakiuria, Poor quality sleep — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Very edgy last night, confusion and my head felt like it had lead weighing it down. Urinated much more then normal. Sleep was poor.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Survey response — days 1–6 daily, dose 1MedDRA: Disturbance in attention, Pain — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: Still not feeling focused and little pains around my bodyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-18
-
2021-03-19
Survey response — days 1–6 daily, dose 1MedDRA: Disturbance in attention — Feeling: GoodFree text: Im still having concentration issuesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-29
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2021-04-12
Dose 2 — Pfizer-BioNTech
- 2021-04-19
- 2021-05-03
- 2021-05-19
- 2021-05-24
-
2021-07-12
Survey response — 3 months, dose 2MedDRA: Lower respiratory tract infection, Pain — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Very bad chest cold and sharp pains I. Random areas of my bodyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-10-11
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2022-04-12
Survey response — 12 months, dose 2MedDRA: Back pain, Injection site cyst, Injection site swelling, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Bump in my arm where the shot was. Doctor says it's a syst and I've had lower back pain · Healthcare visit (other): My regular doctorMedDRA releases: 2024-11 · check-in free text available
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2022-04-12
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-19
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-15 | Pfizer-BioNTech | |
| 2 | 2021-04-12 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-12 | Successful 2022-04-19 |
Not applicable - Accidental Reporting |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Cant concentrate
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Very edgy last night, confusion and my head felt like it had lead weighing it down. Urinated much more then normal. Sleep was poor.
Systemic reaction (other): Still not feeling focused and little pains around my body
Systemic reaction (other): Im still having concentration issues
Release 9 — 3 months, dose 2
Symptoms: Very bad chest cold and sharp pains I. Random areas of my body
Release 11 — 12 months, dose 2
Symptoms: Bump in my arm where the shot was. Doctor says it's a syst and I've had lower back pain
Healthcare visit (other): My regular doctor
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 | Back pain | · | · | ✓ |
| SD | Injection site cyst | · | · | ✓ |
| SD | Injection site swelling | · | · | ✓ |
| SD | Lower respiratory tract infection | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SRO | Confusional state | ✓ | ✓ | ✓ |
| SRO | Disturbance in attention | ✓ | ✓ | ✓ |
| SRO | Head discomfort | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pollakiuria | ✓ | ✓ | ✓ |
| SRO | Poor quality sleep | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release