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ZX2-19191-43002

2 vaccinations 3 coded responses 5 check-ins 3 free-text entries 1 call case
Sex
Female
Age at first dose
31-35
ZIP prefix
916 / CA
Registered
2021-03-11
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-17
    Dose 1 — Pfizer-BioNTech
  2. 2021-03-10
    Dose 2 — Pfizer-BioNTech
  3. 2021-03-11
    Registered in v-safe
  4. 2021-03-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Deep vein thrombosis, Office visit, Pre-existing disease, Pulmonary embolism — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: On Feb 23rd I was diagnosed with an extensive blood clot in my leg (DVT) and some pulmonary embolisms (blood clot in the lungs), the doctors told me it was due to a knee surgery I had Feb 1st, my birth control pills and I have May-Thurner syndrome, but I wondered if the vaccine could also of contributed since I had my blood clot less than a week after my 1st vaccine and I read about links between vaccines and blood clots in the news
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-11
    Report sent to call center — days 1–6 daily, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  6. 2021-03-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Adverse reaction, Pre-existing disease — Feeling: Fair · Site: Pain · Fatigue or tiredness
    Free text: Symptoms likely due to recent DVT and PE
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-16
    Survey response — days 1–6 daily, dose 2
    MedDRA: Fatigue, Pre-existing disease — Feeling: Fair · Fatigue or tiredness
    Free text: Fatigue may be due to dvt and pulmonary embolism recovery
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-19
    Health check-in — day 7, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  9. 2021-04-21
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  10. 2021-12-13
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-02-17Pfizer-BioNTech
22021-03-10Pfizer-BioNTech

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-11

Systemic reaction (other): On Feb 23rd I was diagnosed with an extensive blood clot in my leg (DVT) and some pulmonary embolisms (blood clot in the lungs), the doctors told me it was due to a knee surgery I had Feb 1st, my birth control pills and I have May-Thurner syndrome, but I wondered if the vaccine could also of contributed since I had my blood clot less than a week after my 1st vaccine and I read about links between vaccines and blood clots in the news

2021-03-12

Systemic reaction (other): Symptoms likely due to recent DVT and PE

2021-03-16

Systemic reaction (other): Fatigue may be due to dvt and pulmonary embolism recovery

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

FieldPreferred term2021-092023-042024-11
SROAdverse reaction ✓ ✓ ✓
SRODeep vein thrombosis ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROOffice visit ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROPulmonary embolism ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release