49U-33056-10738
5 vaccinations
10 coded responses
42 check-ins
10 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 539 / WI
- Registered
- 2021-03-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-15
Registered in v-safe
-
2021-03-15
Dose 1 — Pfizer-BioNTech
- 2021-03-15
- 2021-03-16
- 2021-03-18
- 2021-03-19
- 2021-03-22
- 2021-04-01
-
2021-04-05
Dose 2 — Pfizer-BioNTech
- 2021-04-05
-
2021-04-06
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-08
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Good · Site: Pain · Headache, Muscle or body achesFree text: Pain under left arm at injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-11
- 2021-04-14
- 2021-04-20
- 2021-04-28
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-07-07
-
2021-10-05
Survey response — 6 months, dose 2MedDRA: Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Diagnosed with possible cellulitis infection in left leg below the knee on 10/3.. Prescribed antibiotics. Negative PCR test on 10/1, taken 9/30.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-05
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2021-10-06
-
2021-11-01
Dose 3 — Pfizer-BioNTech
-
2021-11-03
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: Severe sore throat, mild congestionMedDRA releases: 2024-11 · check-in free text available
-
2021-11-04
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Poor · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessFree text: Mild sore throat. Moderate congestion.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-05
Survey response — days 1–6 daily, dose 3MedDRA: Respiratory tract congestion — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tirednessFree text: Moderate to severe congestion.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-06
Survey response — days 1–6 daily, dose 3MedDRA: Respiratory tract congestion — Feeling: Poor · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Moderate congestion.MedDRA releases: 2024-11 · check-in free text available
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2021-11-07
Survey response — days 1–6 daily, dose 3MedDRA: Cough, Respiratory tract congestion — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: Mild congestion, moderate coughMedDRA releases: 2024-11 · check-in free text available
-
2021-11-08
Survey response — day 7, dose 3MedDRA: Cough, Productive cough — Feeling: Fair · Muscle or body aches, Rash, not including the immediate area around the injection siteFree text: Occasional severe cough, little phlegm.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-15
- 2021-11-23
- 2021-12-01
- 2021-12-06
- 2021-12-18
- 2022-02-01
- 2022-05-06
-
2022-05-27
Dose 4 — Pfizer-BioNTech
-
2022-10-17
Dose 5 — Pfizer-BioNTechCo-administered: Flu
- 2022-10-17
- 2022-10-19
- 2022-10-20
- 2022-10-21
- 2022-10-24
-
2022-10-31
Survey response — day 14, dose 5MedDRA: Eye infection — Feeling: GoodFree text: Eye infection. Prescribed Polymixin B eye drops.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-09
- 2022-11-21
- 2022-11-28
- 2023-01-17
- 2023-04-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-15 | Pfizer-BioNTech | |
| 2 | 2021-04-05 | Pfizer-BioNTech | |
| 3 | 2021-11-01 | Pfizer-BioNTech | No |
| 4 | 2022-05-27 | Pfizer-BioNTech | No |
| 5 | 2022-10-17 | Pfizer-BioNTech | Flu |
Call center
1 call center case
1 unsuccessful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Dizziness
Systemic reaction (other): Pain under left arm at injection site.
Release 10 — 6 months, dose 2
Symptoms: Diagnosed with possible cellulitis infection in left leg below the knee on 10/3.. Prescribed antibiotics. Negative PCR test on 10/1, taken 9/30.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Severe sore throat, mild congestion
Systemic reaction (other): Mild sore throat. Moderate congestion.
Systemic reaction (other): Moderate to severe congestion.
Systemic reaction (other): Moderate congestion.
Systemic reaction (other): Mild congestion, moderate cough
Release 10 — day 7, dose 3
Systemic reaction (other): Occasional severe cough, little phlegm.
Release 12 — day 14, dose 5
Symptoms: Eye infection. Prescribed Polymixin B eye drops.
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 | Eye infection | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Productive cough | · | · | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release