ZTR-11541-42819
1 vaccination
7 coded responses
7 check-ins
7 free-text entries
6 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 270 / NC
- Registered
- 2021-09-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
UCV-76464-69083
Child or adolescent in my care · Female · 2021-09-16
8TA-31860-69712
Child or adolescent in my care · Male · 2021-09-16
Z7Y-15819-03908
Adult relative or friend · Male · 2021-09-16
Timeline
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2021-09-16
Registered in v-safe
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2021-09-16
Dose 1 — Pfizer-BioNTech
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2021-09-16
Survey response — day 0, dose 1MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Severe dizzinessMedDRA releases: 2024-11 · check-in free text available
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2021-09-17
Survey response — days 1–6 daily, dose 1MedDRA: Capillary fragility, Dizziness, Gait disturbance, Pain in extremity — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · 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 activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Systemic reaction (other): Severe legs pain w/broken capillaries both legs, severe dizziness impedance of ambulatory w/out assistance · Healthcare visit (other): Would go to er if they did not have terrible wait times, broken capillaries and severe dizziness is extremely concerningMedDRA releases: 2024-11 · check-in free text available
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2021-09-17
Report sent to call center — days 1–6 daily, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
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2021-09-18
Survey response — days 1–6 daily, dose 1MedDRA: Capillary fragility, Dyspnoea, Hypoaesthesia, Hypoglycaemia, Pain in extremity, Paraesthesia, Pre-existing disease — Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · 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: Systemic reaction (other): I take meds for autoimmune and should not have a fever with these meds; numbness and tingling in hands and feet, pain so bad in entire legs 1st day that it broke capillaries at the surface of the skin, legs extremely sore still, hypoglycemia, more??? · Healthcare visit (other): Hypoglycemia unstable, unable to walk without help, more to accountMedDRA releases: 2024-11 · check-in free text available
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2021-09-18
Report sent to call center — days 1–6 daily, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
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2021-09-19
Survey response — days 1–6 daily, dose 1MedDRA: Capillary fragility, Contusion, Dizziness, Pain in extremity — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Severe leg pain continues, broken capillaries have turned into painful bruising, dizziness continuesMedDRA releases: 2024-11 · check-in free text available
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2021-09-19
Report sent to call center — days 1–6 daily, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
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2021-09-20
Survey response — days 1–6 daily, dose 1MedDRA: Capillary fragility, Contusion, Erythema, Skin discolouration — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Red and brown bruising from broken capillariesMedDRA releases: 2024-11 · check-in free text available
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2021-09-20
Report sent to call center — days 1–6 daily, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-09-20
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2021-09-21
Survey response — days 1–6 daily, dose 1MedDRA: Capillary fragility, Contusion — Feeling: Poor · Site: Itching · Fever · 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 activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Bruising where capillaries broke in legs after shotMedDRA releases: 2024-11 · check-in free text available
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2021-09-21
Report sent to call center — days 1–6 daily, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-09-23
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2021-10-08
Survey response — day 21, dose 1MedDRA: Autoimmune disorder, Dysstasia, Gait disturbance, Inflammation, Insomnia, Laboratory test abnormal, Office visit, Pain in extremity, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, 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: Lab work shows autoimmune issues, inflammation, Persistent fever, leg pain, difficulty walking, standing, sleeping, resting · Healthcare visit (other): SpecialistMedDRA releases: 2024-11 · check-in free text available
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2021-10-08
Report sent to call center — day 21, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-09-16 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-09-17 | Unsuccessful | |
| 2021-09-18 | Unsuccessful | |
| 2021-09-19 | Unsuccessful | |
| 2021-09-20 | Unsuccessful | |
| 2021-09-21 | Unsuccessful | |
| 2021-10-08 | Unsuccessful |
Free text
Release 9 — day 0, dose 1
Systemic reaction (other): Severe dizziness
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Severe legs pain w/broken capillaries both legs, severe dizziness impedance of ambulatory w/out assistance
Healthcare visit (other): Would go to er if they did not have terrible wait times, broken capillaries and severe dizziness is extremely concerning
Systemic reaction (other): I take meds for autoimmune and should not have a fever with these meds; numbness and tingling in hands and feet, pain so bad in entire legs 1st day that it broke capillaries at the surface of the skin, legs extremely sore still, hypoglycemia, more??? cut off by CDC
Healthcare visit (other): Hypoglycemia unstable, unable to walk without help, more to account
Systemic reaction (other): Severe leg pain continues, broken capillaries have turned into painful bruising, dizziness continues
Systemic reaction (other): Red and brown bruising from broken capillaries
Systemic reaction (other): Bruising where capillaries broke in legs after shot
Release 10 — day 21, dose 1
Symptoms: Lab work shows autoimmune issues, inflammation, Persistent fever, leg pain, difficulty walking, standing, sleeping, resting
Healthcare visit (other): Specialist
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 | Capillary fragility | · | · | ✓ |
| HCVO | Dizziness | · | · | ✓ |
| HCVO | Dyspnoea | · | · | ✓ |
| HCVO | Hypoglycaemia | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Autoimmune disorder | · | · | ✓ |
| SD | Dysstasia | · | · | ✓ |
| SD | Gait disturbance | · | · | ✓ |
| SD | Inflammation | · | · | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Laboratory test abnormal | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Capillary fragility | · | · | ✓ |
| SRO | Contusion | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Erythema | · | · | ✓ |
| SRO | Gait disturbance | · | · | ✓ |
| SRO | Hypoaesthesia | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Paraesthesia | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Skin discolouration | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release