3JM-15996-07461
5 vaccinations
6 coded responses
35 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 581 / ND
- Registered
- 2021-01-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Dose 1 — Pfizer-BioNTech
-
2021-01-31
Registered in v-safe
- 2021-02-01
-
2021-02-02
Survey response — day 7, dose 1MedDRA: Musculoskeletal stiffness — Feeling: Good · Site: PainFree text: Morning leg stiffness on awakening, but at my age it happens :-)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
-
2021-02-16
Survey response — day 21, dose 1MedDRA: Gastrointestinal disorder, Pre-existing disease — Feeling: FairFree text: Digestive issues , but I had GERD and constipation before my Covid vaccine, so things are likely unrelated and coincidental. Im other wise feeling Ok :-)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-18
Dose 2 — Pfizer-BioNTech
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
-
2021-04-01
Survey response — day 42, dose 2MedDRA: Fatigue, Pre-existing disease, Tinnitus — Feeling: FairFree text: Some fatigue as well as tinnitus. Unknown of course if they are related to the vaccine. I did have an episode of tinnitus in the past, prior to the vaccine. And of course, fatigue could be due to lots of reasons unrelated to vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-20
Survey response — 3 months, dose 2MedDRA: Dyspepsia, Oesophageal discomfort, Pre-existing disease — Feeling: GoodFree text: Indigestion and esophageal discomfort- but Ive had reflux etc. for many years, so unlikely vaccine relatedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-08-19
Survey response — 6 months, dose 2MedDRA: Orthostatic hypotension, Pre-existing disease — Feeling: GoodFree text: Some infrequent orthostatic hypotension. Honestly, it precedes vaccinations, and I was also exercising in hot weather during the episode last week, so probably unrelated to vaccines.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-01
Dose 3 — Pfizer-BioNTech
- 2021-09-30
- 2021-10-06
- 2021-10-13
- 2021-12-01
- 2022-03-02
-
2022-04-20
Dose 4 — Pfizer-BioNTech
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-05-25
- 2022-06-01
-
2022-07-20
Survey response — 3 months, dose 4MedDRA: Office visit, Orthostatic hypotension — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Orthostatic hypotension · Healthcare visit (other): Normal office appointmentMedDRA releases: 2024-11 · check-in free text available
-
2022-07-20
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-07-21
-
2022-08-03
Call successfulDoes not wish to fill out VAERS report
-
2022-08-04
Callback requested for03:30PM ET
-
2022-10-03
Dose 5 — Pfizer-BioNTechCo-administered: Flu
- 2022-10-09
- 2022-10-13
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-11-07
- 2022-11-14
- 2023-01-02
- 2023-04-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Pfizer-BioNTech | |
| 2 | 2021-02-18 | Pfizer-BioNTech | |
| 3 | 2021-09-01 | Pfizer-BioNTech | No |
| 4 | 2022-04-20 | Pfizer-BioNTech | No |
| 5 | 2022-10-03 | Pfizer-BioNTech | Flu |
Call center
1 call center case
1 successful
Free text
Release 3 — day 7, dose 1
Systemic reaction (other): Morning leg stiffness on awakening, but at my age it happens :-)
Release 4 — day 21, dose 1
Symptoms: Digestive issues , but I had GERD and constipation before my Covid vaccine, so things are likely unrelated and coincidental. Im other wise feeling Ok :-)
Release 6 — day 42, dose 2
Symptoms: Some fatigue as well as tinnitus. Unknown of course if they are related to the vaccine. I did have an episode of tinnitus in the past, prior to the vaccine. And of course, fatigue could be due to lots of reasons unrelated to vaccine.
Release 8 — 3 months, dose 2
Symptoms: Indigestion and esophageal discomfort- but Ive had reflux etc. for many years, so unlikely vaccine related
Release 9 — 6 months, dose 2
Symptoms: Some infrequent orthostatic hypotension. Honestly, it precedes vaccinations, and I was also exercising in hot weather during the episode last week, so probably unrelated to vaccines.
Release 12 — 3 months, dose 4
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 | Office visit | · | · | ✓ |
| SD | Dyspepsia | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SD | Oesophageal discomfort | ✓ | ✓ | ✓ |
| SD | Orthostatic hypotension | ✓ | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Tinnitus | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release