ZK5-21785-62513
3 vaccinations
5 coded responses
34 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 128 / NY
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
7Q4-10552-28907
Child or adolescent in my care · Male · 2021-08-11
Timeline
-
2021-01-20
Registered in v-safe
-
2021-01-20
Dose 1 — Pfizer-BioNTech
-
2021-01-21
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-27
-
2021-02-03
Survey response — day 14, dose 1MedDRA: Diarrhoea — Feeling: GoodFree text: I had one acute bout of severe diarrhea on Jan 30, but fortunately symptoms did not continue. Otherwise, no changes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-10
Dose 2 — Pfizer-BioNTech
- 2021-02-10
-
2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-02-13
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Paranasal sinus hypersecretion, Rhinorrhoea — Feeling: Good · Site: ItchingFree text: Nasal discharge, drippy nose. Mild.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-15
Survey response — days 1–6 daily, dose 2MedDRA: Paranasal sinus hypersecretion — Feeling: Fair · Fatigue or tirednessFree text: Nasal discharge, runny nose: Mild.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-16
- 2021-02-21
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-19
- 2021-03-26
- 2021-05-14
- 2021-08-11
-
2021-11-03
Dose 3 — Pfizer-BioNTech
- 2021-11-03
-
2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-11-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
- 2021-11-09
- 2021-11-10
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2021-12-15
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2022-02-02
Survey response — 3 months, dose 3MedDRA: Office visit, Vision blurred — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Blurry distance vision in one eye. · Healthcare visit (other): Visit to eye doctor.MedDRA releases: 2024-11 · check-in free text available
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2022-02-02
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2022-03-30
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2022-05-04
Survey response — 6 months, dose 3MedDRA: Diarrhoea, Fatigue, Flatulence, Headache, Nasal congestion, Nasopharyngitis, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative — 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 · Outpatient clinic or urgent care clinic visitFree text: Cold symptoms, last 2 weeks: diarrhea with gas, fatigue, headache, nasal discharge, sore throat, nasal congestion. Negative Covid tests by 3 home tests and PCR. Negative strep test result.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-04
Report sent to call center — 6 months, dose 3Be 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)
- 2022-05-05
- 2022-11-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Pfizer-BioNTech | |
| 2 | 2021-02-10 | Pfizer-BioNTech | |
| 3 | 2021-11-03 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-02 | Unsuccessful | |
| 2022-05-04 | Unsuccessful |
Free text
Release 3 — day 14, dose 1
Symptoms: I had one acute bout of severe diarrhea on Jan 30, but fortunately symptoms did not continue. Otherwise, no changes.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Nasal discharge, drippy nose. Mild.
Systemic reaction (other): Nasal discharge, runny nose: Mild.
Release 11 — 3 months, dose 3
Symptoms: Blurry distance vision in one eye.
Healthcare visit (other): Visit to eye doctor.
Release 11 — 6 months, dose 3
Symptoms: Cold symptoms, last 2 weeks: diarrhea with gas, fatigue, headache, nasal discharge, sore throat, nasal congestion. Negative Covid tests by 3 home tests and PCR. Negative strep test result.
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 | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Flatulence | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vision blurred | · | · | ✓ |
| SRO | Paranasal sinus hypersecretion | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release