2Q9-67818-75004
3 vaccinations
5 coded responses
11 check-ins
5 free-text entries
0 call cases
- Sex
- —
- Age at first dose
- 41-45
- ZIP prefix
- 980 / WA
- Registered
- 2021-11-06
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-04-03
Dose 1 — Pfizer-BioNTech
-
2021-04-24
Dose 2 — Pfizer-BioNTech
-
2021-11-03
Dose 3 — Moderna
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2021-11-06
Registered in v-safe
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2021-11-06
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-11-07
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-11-09
Survey response — days 1–6 daily, dose 3MedDRA: Swelling face — Feeling: Fair · Fever · Headache · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sudden appearance of a mid-sized bump in the middle of me forehead.MedDRA releases: 2024-11 · check-in free text available
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2021-11-10
Survey response — day 7, dose 3MedDRA: Swelling face — Feeling: Poor · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: an unprecedented lump in the middle of my forehead that was more raised yesterday than todayMedDRA releases: 2024-11 · check-in free text available
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2021-11-17
Survey response — day 14, dose 3MedDRA: Fatigue, Somnolence — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: A few hours after my last check in, I became extremely fatigued and laid down between about 5-8pm without sleeping. I normally can't fall asleep before around 11pm, but that night I fell asleep for the night around 9:30pm.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-24
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2021-12-01
Survey response — day 28, dose 3MedDRA: Condition aggravated, Muscle strain, Pain, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: A movement disorder, emerging as overnight teeth grinding in 2016, is worsening. Lately, 1 side of my neck has begun to strain, & today that pain is, for the 1st time, to a point of painful burning that I can only make relax a few seconds at a time.MedDRA releases: 2024-11 · check-in free text available
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2021-12-08
Survey response — day 35, dose 3MedDRA: Condition aggravated, Muscle strain, Otitis media, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: A left side middle ear infection, and a muscle strain at top left side of chest just below my shoulder blade. The latter, and I think possibly also the former in part somewhat, are due to worsening involuntary mouth movements over the years.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-15
- 2022-02-07
- 2022-05-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-03 | Pfizer-BioNTech | No |
| 2 | 2021-04-24 | Pfizer-BioNTech | No |
| 3 | 2021-11-03 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sudden appearance of a mid-sized bump in the middle of me forehead.
Release 10 — day 7, dose 3
Systemic reaction (other): an unprecedented lump in the middle of my forehead that was more raised yesterday than today
Release 10 — day 14, dose 3
Symptoms: A few hours after my last check in, I became extremely fatigued and laid down between about 5-8pm without sleeping. I normally can't fall asleep before around 11pm, but that night I fell asleep for the night around 9:30pm.
Release 10 — day 28, dose 3
Symptoms: A movement disorder, emerging as overnight teeth grinding in 2016, is worsening. Lately, 1 side of my neck has begun to strain, & today that pain is, for the 1st time, to a point of painful burning that I can only make relax a few seconds at a time. cut off by CDC
Release 10 — day 35, dose 3
Symptoms: A left side middle ear infection, and a muscle strain at top left side of chest just below my shoulder blade. The latter, and I think possibly also the former in part somewhat, are due to worsening involuntary mouth movements over the years.
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 |
|---|---|---|---|---|
| SD | Condition aggravated | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Muscle strain | · | · | ✓ |
| SD | Otitis media | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Somnolence | · | · | ✓ |
| SRO | Swelling face | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release