3SF-30305-00840
4 vaccinations
8 coded responses
30 check-ins
8 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 945 / CA
- Registered
- 2021-01-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-17
Registered in v-safe
-
2021-01-17
Dose 1 — Pfizer-BioNTech
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-31
-
2021-02-05
Dose 2 — Pfizer-BioNTech
-
2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Pain — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessFree text: Got 2nd dose on 2/5/21. Felt fine for 12 hours, then got severe chills but no fever. 2/6/21 woke up with moderate body aches.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-08
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Immediate post-injection reaction, Pain — Feeling: Good · HeadacheFree text: 12 hours after receiving my 2nd Pfizer dose I experienced intense chills, but without fever (temp was normal). The following day, I had body aches which lasted about 12h.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-19
-
2021-02-27
Survey response — day 21, dose 2MedDRA: Rectal haemorrhage — Feeling: GoodFree text: Rectal bleedingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
-
2021-03-12
Survey response — day 35, dose 2MedDRA: Headache — Feeling: GoodFree text: Mild headache. 2 on the 0-10 scale.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
-
2021-05-07
Survey response — 3 months, dose 2MedDRA: Headache — Feeling: FairFree text: HeadacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-08-06
Survey response — 6 months, dose 2MedDRA: Chest injury, Fall, Limb injury — Feeling: FairFree text: I fell. Hurt hand and upper ribMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-10-02
Dose 3 — Pfizer-BioNTech
-
2022-02-07
Survey response — 12 months, dose 2MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
-
2022-04-03
Dose 4 — Pfizer-BioNTech
- 2022-04-19
- 2022-04-24
- 2022-05-01
-
2022-05-08
Survey response — day 35, dose 4MedDRA: Cough, Nasal congestion, Pre-existing disease, SARS-CoV-2 test negative — Feeling: GoodFree text: Nasal congestion Intermittent dry cough Consistent with seasonal allergy symptoms I've had in the past I took a covid self test on 5/4/2022 and it showed negative for covid-19MedDRA releases: 2024-11 · check-in free text available
- 2022-05-15
- 2022-07-03
- 2022-10-02
- 2023-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-17 | Pfizer-BioNTech | |
| 2 | 2021-02-05 | Pfizer-BioNTech | |
| 3 | 2021-10-02 | Pfizer-BioNTech | No |
| 4 | 2022-04-03 | Pfizer-BioNTech | No |
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Got 2nd dose on 2/5/21. Felt fine for 12 hours, then got severe chills but no fever. 2/6/21 woke up with moderate body aches.
Systemic reaction (other): 12 hours after receiving my 2nd Pfizer dose I experienced intense chills, but without fever (temp was normal). The following day, I had body aches which lasted about 12h.
Release 4 — day 21, dose 2
Symptoms: Rectal bleeding
Release 5 — day 35, dose 2
Symptoms: Mild headache. 2 on the 0-10 scale.
Release 8 — 3 months, dose 2
Symptoms: Headache
Release 9 — 6 months, dose 2
Symptoms: I fell. Hurt hand and upper rib
Release 11 — 12 months, dose 2
Symptoms: Sore throat
Release 11 — day 35, dose 4
Symptoms: Nasal congestion Intermittent dry cough Consistent with seasonal allergy symptoms I've had in the past I took a covid self test on 5/4/2022 and it showed negative for covid-19
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 | Chest injury | ✓ | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fall | ✓ | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Limb injury | ✓ | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rectal haemorrhage | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release