ZQL-13151-34506
3 vaccinations
4 coded responses
32 check-ins
4 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 201 / VA
- Registered
- 2020-12-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-20
Registered in v-safe
-
2020-12-20
Dose 1 — Pfizer-BioNTech
- 2020-12-20
- 2020-12-21
- 2020-12-22
- 2020-12-23
- 2020-12-25
- 2020-12-27
- 2021-01-03
-
2021-01-10
Dose 2 — Pfizer-BioNTech
- 2021-01-10
- 2021-01-13
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-24
- 2021-02-03
- 2021-02-07
- 2021-02-16
- 2021-02-21
- 2021-04-11
-
2021-07-11
Survey response — 6 months, dose 2MedDRA: Cough, Office visit, Rhinitis, SARS-CoV-2 test negative — Feeling: Fair · 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: Symptoms: Coryza, cough · Healthcare visit (other): CVS minute clinic for rapid covid test negativMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-11
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-20
-
2021-09-28
Dose 3 — Pfizer-BioNTech
-
2021-09-30
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-10-01
- 2021-10-02
- 2021-10-04
- 2021-10-07
- 2021-10-13
- 2021-10-19
- 2021-10-26
- 2021-11-02
-
2021-11-09
Survey response — day 42, dose 3MedDRA: Cough, Fatigue, Feeling abnormal, Rhinitis, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Coryza, cough, farigue. Started11/7I think it's just a cold but fairly miserable. Negative in home rapid antigen test todayMedDRA releases: 2024-11 · check-in free text available
-
2021-12-28
Survey response — 3 months, dose 3MedDRA: Eye infection, Unevaluable event — 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: Symptoms: Eye infection · Healthcare visit (other): Ct scanMedDRA releases: 2024-11 · check-in free text available
-
2021-12-28
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)
-
2021-12-29
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-29
-
2022-09-28
Survey response — 12 months, dose 3MedDRA: Myalgia, Office visit, Pre-existing disease, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Prostate cancer stage 3 Fever myalgia x 24 hour after combined Covid/ flu/ shingles vaccine on same dsy · Healthcare visit (other): For vaccine reaction, just bed rest x 1 day. Extensive out pt eval, hormonal and radiation for prostate cancerMedDRA releases: 2024-11 · check-in free text available
-
2022-09-28
Report sent to call center — 12 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-09-29
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-20 | Pfizer-BioNTech | |
| 2 | 2021-01-10 | Pfizer-BioNTech | |
| 3 | 2021-09-28 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-11 | Successful | Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-12-28 | Successful 2021-12-29 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-09-28 | Successful 2022-09-29 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 9 — 6 months, dose 2
Symptoms: Coryza, cough
Healthcare visit (other): CVS minute clinic for rapid covid test negativ
Release 10 — day 42, dose 3
Symptoms: Coryza, cough, farigue. Started11/7I think it's just a cold but fairly miserable. Negative in home rapid antigen test today
Release 10 — 3 months, dose 3
Release 12 — 12 months, dose 3
Symptoms: Prostate cancer stage 3 Fever myalgia x 24 hour after combined Covid/ flu/ shingles vaccine on same dsy
Healthcare visit (other): For vaccine reaction, just bed rest x 1 day. Extensive out pt eval, hormonal and radiation for prostate cancer
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 | ✓ | ✓ | ✓ |
| HCVO | Pre-existing disease | · | · | ✓ |
| HCVO | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Eye infection | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Feeling abnormal | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinitis | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release