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233-97400-58409

4 vaccinations 3 coded responses 14 check-ins 3 free-text entries 0 call cases
Sex
Male
Age at first dose
46-50
ZIP prefix
653 / MO
Registered
2022-07-12
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
2T6-11820-06419 Child or adolescent in my care · Male · 2022-07-12

Timeline

  1. 2021-03-27
    Dose 1 — Pfizer-BioNTech
  2. 2021-04-17
    Dose 2 — Pfizer-BioNTech
  3. 2021-11-30
    Dose 3 — Pfizer-BioNTech
  4. 2022-07-11
    Dose 4 — Pfizer-BioNTech
  5. 2022-07-12
    Registered in v-safe
  6. 2022-07-12
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  7. 2022-07-13
    Survey response — days 1–6 daily, dose 4
    MedDRA: Dizziness — Feeling: Good · Site: Pain · Fatigue or tiredness
    Free text: dizziness
    MedDRA releases: 2024-11 · check-in free text available
  8. 2022-07-14
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain · None
    Adult check-in
  9. 2022-07-15
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  10. 2022-07-16
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  11. 2022-07-17
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  12. 2022-07-18
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  13. 2022-07-25
    Survey response — day 14, dose 4
    MedDRA: Palpitations, Pre-existing disease — Feeling: Good
    Free text: I noticed some heart palpitations, intermittently, for a few days. Now I have had these before in the past so I cannot confirm if they are related to the shot. Just noting it though.
    MedDRA releases: 2024-11 · check-in free text available
  14. 2022-08-01
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  15. 2022-08-08
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  16. 2022-08-16
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  17. 2022-08-22
    Survey response — day 42, dose 4
    MedDRA: Palpitations, Pre-existing disease — Feeling: Good
    Free text: I have had intermittent heart palpitations. I cant say if its shot related as I have had these in the past. Previous shots did not do this that I recall. They are not frequent and I am wearing a monitor to track these. otherwise everything is normal.
    MedDRA releases: 2024-11 · check-in free text available
  18. 2022-10-10
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  19. 2023-01-09
    Health check-in — 6 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-27Pfizer-BioNTech No
22021-04-17Pfizer-BioNTech No
32021-11-30Pfizer-BioNTech No
42022-07-11Pfizer-BioNTech No

Free text

Release 12 — days 1–6 daily, dose 4

2022-07-13

Systemic reaction (other): dizziness

Release 12 — day 14, dose 4

2022-07-25

Symptoms: I noticed some heart palpitations, intermittently, for a few days. Now I have had these before in the past so I cannot confirm if they are related to the shot. Just noting it though.

Release 12 — day 42, dose 4

2022-08-22

Symptoms: I have had intermittent heart palpitations. I cant say if its shot related as I have had these in the past. Previous shots did not do this that I recall. They are not frequent and I am wearing a monitor to track these. otherwise everything is normal. cut off by CDC

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
SDPalpitations · · ✓
SDPre-existing disease · · ✓
SRODizziness · · ✓

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