3RM-26881-90067
5 vaccinations
7 coded responses
67 check-ins
6 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 112 / NY
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Registered in v-safe
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2021-03-11
Dose 1 — Pfizer-BioNTech
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2021-03-11
Health check-in — day 0, dose 1Feeling: Good · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-12
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tiredness, NauseaAdult check-in
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-25
-
2021-04-01
Dose 2 — Pfizer-BioNTech
-
2021-04-01
Health check-in — day 0, dose 2Feeling: Good · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-07-01
- 2021-09-30
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2021-10-26
Dose 3 — Pfizer-BioNTech
- 2021-10-26
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2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
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2022-01-25
Survey response — 3 months, dose 3MedDRA: Exposure to SARS-CoV-2 — Feeling: GoodFree text: Close contact with a Covid-19 positive patient who was not aware of positive Covid-19 diagnosis at the time, but who had refused to wear a mask during close platonic social contact. I was wearing a mask. We were in an indoor environment.MedDRA releases: 2024-11 · check-in free text available
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2022-04-07
Dose 4 — Pfizer-BioNTech
- 2022-04-07
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2022-04-08
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2022-04-09
Survey response — days 1–6 daily, dose 4MedDRA: Chills — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Slight chills yesterday after reported symptoms on 04/08/2022.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-10
- 2022-04-11
- 2022-04-12
- 2022-04-13
- 2022-04-14
- 2022-04-21
- 2022-04-28
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2022-05-05
Survey response — day 28, dose 4MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: A reoccurrence of herpes in my rectal area. Awaiting a message response from my primary care physician.MedDRA releases: 2024-11 · check-in free text available
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2022-05-05
Report sent to call center — day 28, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-05-06
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2022-05-06
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-05-12
- 2022-05-19
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2022-07-07
Survey response — 3 months, dose 4MedDRA: Anorectal discomfort, Haemorrhoids, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Hemorrhoids discomfort in rectal and anal areas. Colonoscopy scheduled on July 29, 2022, to verify diagnosis and treatment. · Healthcare visit (other): In person doctor's office appointment and examination.MedDRA releases: 2024-11 · check-in free text available
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2022-07-07
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-07-08
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2022-07-08
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-09-30
Dose 5 — Pfizer-BioNTech
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2022-09-30
Health check-in — day 0, dose 5Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-10-01
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2022-10-02
- 2022-10-03
- 2022-10-04
- 2022-10-05
- 2022-10-06
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-10-28
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2022-11-04
Survey response — day 35, dose 5MedDRA: Gingival erythema, Gingival pain, Gingival swelling, Tooth disorder, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Dental issues. Swollen, painful, and red gums in mouth. · Healthcare visit (other): Scheduled appointment with Dentist on 11/07/2022.MedDRA releases: 2024-11 · check-in free text available
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2022-11-04
Report sent to call center — day 35, dose 5Get care from a doctor or other healthcare professional1 call case(s)
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2022-11-07
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-11-11
Survey response — day 42, dose 5MedDRA: Dental operation, Infection, Office visit, Surgery, Tooth extraction, Tooth fracture, Tooth infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I had an infected broken tooth removed on 11/08/2022, & a graph preparation for a forecasted tooth implant. Dental surgery is healing properly, & appears to be successful as of 11/11/2022, with a two week follow up with dental surgeon on 11/22/2022. · Healthcare visit (other): Emergency dental visit and surgery because of infection and tooth removal.MedDRA releases: 2024-11 · check-in free text available
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2022-11-11
Report sent to call center — day 42, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-11-14
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2022-11-15
Call successfulNot applicable - Accidental Reporting
- 2022-12-30
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2023-03-31
Survey response — 6 months, dose 5MedDRA: Adverse drug reaction, Adverse reaction, Dental bone graft, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
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2023-03-31
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professional1 call case(s)
- 2023-04-03
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2023-04-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Pfizer-BioNTech | |
| 2 | 2021-04-01 | Pfizer-BioNTech | |
| 3 | 2021-10-26 | Pfizer-BioNTech | No |
| 4 | 2022-04-07 | Pfizer-BioNTech | No |
| 5 | 2022-09-30 | Pfizer-BioNTech | No |
Call center
5 call center cases
5 successful
Free text
Release 11 — 3 months, dose 3
Symptoms: Close contact with a Covid-19 positive patient who was not aware of positive Covid-19 diagnosis at the time, but who had refused to wear a mask during close platonic social contact. I was wearing a mask. We were in an indoor environment.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Slight chills yesterday after reported symptoms on 04/08/2022.
Release 11 — day 28, dose 4
Symptoms: A reoccurrence of herpes in my rectal area. Awaiting a message response from my primary care physician.
Release 12 — 3 months, dose 4
Symptoms: Hemorrhoids discomfort in rectal and anal areas. Colonoscopy scheduled on July 29, 2022, to verify diagnosis and treatment.
Healthcare visit (other): In person doctor's office appointment and examination.
Release 12 — day 35, dose 5
Symptoms: Dental issues. Swollen, painful, and red gums in mouth.
Healthcare visit (other): Scheduled appointment with Dentist on 11/07/2022.
Release 12 — day 42, dose 5
Symptoms: I had an infected broken tooth removed on 11/08/2022, & a graph preparation for a forecasted tooth implant. Dental surgery is healing properly, & appears to be successful as of 11/11/2022, with a two week follow up with dental surgeon on 11/22/2022. cut off by CDC
Healthcare visit (other): Emergency dental visit and surgery because of infection and tooth removal.
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 | Adverse reaction | · | · | ✓ |
| HCVO | Infection | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Surgery | · | · | ✓ |
| HCVO | Tooth extraction | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Adverse drug reaction | · | · | ✓ |
| SD | Anorectal discomfort | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Dental bone graft | · | · | ✓ |
| SD | Dental operation | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Gingival erythema | · | · | ✓ |
| SD | Gingival pain | · | · | ✓ |
| SD | Gingival swelling | · | · | ✓ |
| SD | Haemorrhoids | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Tooth disorder | · | · | ✓ |
| SD | Tooth extraction | · | · | ✓ |
| SD | Tooth fracture | · | · | ✓ |
| SD | Tooth infection | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release