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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

  1. 2021-04-03
    Dose 1 — Pfizer-BioNTech
  2. 2021-04-24
    Dose 2 — Pfizer-BioNTech
  3. 2021-11-03
    Dose 3 — Moderna
  4. 2021-11-06
    Registered in v-safe
  5. 2021-11-06
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  6. 2021-11-07
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities
    Adult check-in
  7. 2021-11-09
    Survey response — days 1–6 daily, dose 3
    MedDRA: Swelling face — Feeling: Fair · Fever · Headache · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Sudden appearance of a mid-sized bump in the middle of me forehead.
    MedDRA releases: 2024-11 · check-in free text available
  8. 2021-11-10
    Survey response — day 7, dose 3
    MedDRA: 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 activities
    Free text: an unprecedented lump in the middle of my forehead that was more raised yesterday than today
    MedDRA releases: 2024-11 · check-in free text available
  9. 2021-11-17
    Survey response — day 14, dose 3
    MedDRA: Fatigue, Somnolence — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free 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
  10. 2021-11-24
    Health check-in — day 21, dose 3
    Feeling: Fair
    Adult check-in
  11. 2021-12-01
    Survey response — day 28, dose 3
    MedDRA: Condition aggravated, Muscle strain, Pain, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free 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
  12. 2021-12-08
    Survey response — day 35, dose 3
    MedDRA: 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 activities
    Free 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
  13. 2021-12-15
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  14. 2022-02-07
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  15. 2022-05-04
    Health check-in — 6 months, dose 3
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-03Pfizer-BioNTech No
22021-04-24Pfizer-BioNTech No
32021-11-03Moderna No

Free text

Release 10 — days 1–6 daily, dose 3

2021-11-09

Systemic reaction (other): Sudden appearance of a mid-sized bump in the middle of me forehead.

Release 10 — day 7, dose 3

2021-11-10

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

2021-11-17

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

2021-12-01

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

2021-12-08

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

FieldPreferred term2021-092023-042024-11
SDCondition aggravated · · ✓
SDFatigue · · ✓
SDMuscle strain · · ✓
SDOtitis media · · ✓
SDPain · · ✓
SDPre-existing disease · · ✓
SDSomnolence · · ✓
SROSwelling face · · ✓

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