3XU-19484-67800
5 vaccinations
12 coded responses
62 check-ins
11 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 800 / CO
- Registered
- 2021-02-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Dose 1 — Pfizer-BioNTech
-
2021-02-15
Registered in v-safe
- 2021-02-15
-
2021-02-16
Survey response — days 1–6 daily, dose 1MedDRA: Diarrhoea — Feeling: Good · Site: Pain · Diarrhea · Be unable to do your normal daily activitiesFree text: The diarrhea began yesterday after my survey check in.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-27
-
2021-03-06
Dose 2 — Pfizer-BioNTech
-
2021-03-06
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: GoodFree text: Its only been about 30 minutes so might be to soon to tellMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-06-05
- 2021-09-04
-
2021-09-26
Dose 3 — Pfizer-BioNTech
- 2021-09-30
- 2021-10-01
- 2021-10-02
- 2021-10-03
- 2021-10-10
- 2021-10-17
- 2021-10-24
- 2021-10-31
- 2021-11-07
-
2021-12-26
Survey response — 3 months, dose 3MedDRA: SARS-CoV-2 test negative, Sinusitis — Feeling: GoodFree text: Had a sinus infection for about a week. I tested myself with the Binaxnow kit. The results were negative.MedDRA releases: 2024-11 · check-in free text available
- 2022-03-27
-
2022-06-05
Dose 4 — Pfizer-BioNTech
- 2022-06-05
- 2022-06-06
-
2022-06-07
Survey response — days 1–6 daily, dose 4MedDRA: Pain — Feeling: Good · Site: PainFree text: Had some mild body aches last night but fine todayMedDRA releases: 2024-11 · check-in free text available
- 2022-06-08
- 2022-06-09
- 2022-06-10
- 2022-06-11
- 2022-06-12
- 2022-06-19
- 2022-06-26
-
2022-07-03
Survey response — day 28, dose 4MedDRA: Pain in extremity — Feeling: Good · Be unable to do your normal daily activitiesFree text: Had mild to severe left leg pain on last Monday after submitting this weekly formMedDRA releases: 2024-11 · check-in free text available
- 2022-07-10
- 2022-07-17
- 2022-09-04
-
2022-10-06
Dose 5 — Pfizer-BioNTech
- 2022-10-06
-
2022-10-07
Survey response — days 1–6 daily, dose 5MedDRA: Vaccination site pain — Feeling: Good · Site: PainFree text: Soreness where I received the vaccineMedDRA releases: 2024-11 · check-in free text available
-
2022-10-08
Survey response — days 1–6 daily, dose 5MedDRA: Injection site pain — Feeling: GoodFree text: Mild soreness where I got vaccinatedMedDRA releases: 2024-11 · check-in free text available
- 2022-10-09
-
2022-10-10
Survey response — days 1–6 daily, dose 5MedDRA: Diarrhoea — Feeling: Good · DiarrheaFree text: Just a little diarrheaMedDRA releases: 2024-11 · check-in free text available
- 2022-10-11
-
2022-10-12
Survey response — days 1–6 daily, dose 5MedDRA: Pre-existing disease — Feeling: FairFree text: Possibly getting a sinus infection or it's allergiesMedDRA releases: 2024-11 · check-in free text available
-
2022-10-13
Survey response — day 7, dose 5MedDRA: Nasopharyngitis — Feeling: Fair · HeadacheFree text: I think I'm getting an upper respiratory coldMedDRA releases: 2024-11 · check-in free text available
-
2022-10-20
Survey response — day 14, dose 5MedDRA: Cough, SARS-CoV-2 test negative, Sinusitis — Feeling: FairFree text: Sinus infection and coughing. Tested negative for covid.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-27
- 2022-11-03
- 2022-11-10
- 2022-11-17
- 2023-01-05
-
2023-04-06
Survey response — 6 months, dose 5MedDRA: SARS-CoV-2 test positive, Sinusitis — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Pfizer-BioNTech | |
| 2 | 2021-03-06 | Pfizer-BioNTech | |
| 3 | 2021-09-26 | Pfizer-BioNTech | No |
| 4 | 2022-06-05 | Pfizer-BioNTech | No |
| 5 | 2022-10-06 | Pfizer-BioNTech | No |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): The diarrhea began yesterday after my survey check in.
Release 5 — day 0, dose 2
Systemic reaction (other): Its only been about 30 minutes so might be to soon to tell
Release 10 — 3 months, dose 3
Symptoms: Had a sinus infection for about a week. I tested myself with the Binaxnow kit. The results were negative.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Had some mild body aches last night but fine today
Release 12 — day 28, dose 4
Symptoms: Had mild to severe left leg pain on last Monday after submitting this weekly form
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Soreness where I received the vaccine
Systemic reaction (other): Mild soreness where I got vaccinated
Systemic reaction (other): Just a little diarrhea
Systemic reaction (other): Possibly getting a sinus infection or it's allergies
Release 12 — day 7, dose 5
Systemic reaction (other): I think I'm getting an upper respiratory cold
Release 12 — day 14, dose 5
Symptoms: Sinus infection and coughing. Tested negative for covid.
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 | Cough | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Nasopharyngitis | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Vaccination site pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release