4A4-97287-99836
4 vaccinations
5 coded responses
35 check-ins
5 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 604 / IL
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Dose 1 — Pfizer-BioNTech
-
2021-01-29
Registered in v-safe
-
2021-01-29
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-12
-
2021-02-16
Dose 2 — Pfizer-BioNTech
-
2021-02-19
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessFree text: Fogginess. But thats may be related to the COVID, a lingering effect.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-09
-
2021-03-16
Survey response — day 28, dose 2MedDRA: Condition aggravated, Pre-existing disease, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Motor control in my legs had reemerged. It as if my legs disappeared and collapsed to the ground. I was able to get up. Also, my stuttering is back. · Healthcare visit (other): Appointment with NeurologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Report sent to call center — day 28, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-24
Survey response — day 35, dose 2MedDRA: Back pain, Office visit, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Back pain. I have had back problems in the past, nut since I received my pfizer shot, my back has gotten an order of magnitude worse. Who knows if there is a correlation or not. But something changed. · Healthcare visit (other): See a pain doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-24
Report sent to call center — day 35, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-30
Survey response — day 42, dose 2MedDRA: Ataxia, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Still have a fair amount of loss of muscle control. · Healthcare visit (other): NeurologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-30
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-20
- 2021-08-17
-
2021-09-24
Dose 3 — Pfizer-BioNTech
- 2021-10-06
- 2021-10-08
- 2021-10-17
- 2021-10-22
- 2021-10-29
- 2021-11-05
- 2021-12-24
-
2022-01-20
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-25
-
2022-04-07
Dose 4 — Moderna
-
2022-04-14
Health check-in — day 7, dose 4Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness, VomitingAdult check-in
-
2022-04-21
Survey response — day 14, dose 4MedDRA: Nausea, Vomiting — Feeling: GoodFree text: I vomited the morning after. Nausea stayed with me for only about 30 minutesMedDRA releases: 2024-11 · check-in free text available
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-05-21
- 2022-07-07
- 2022-10-06
- 2023-04-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Pfizer-BioNTech | |
| 2 | 2021-02-16 | Pfizer-BioNTech | |
| 3 | 2021-09-24 | Pfizer-BioNTech | No |
| 4 | 2022-04-07 | Moderna | No |
Call center
3 call center cases
3 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Fogginess. But thats may be related to the COVID, a lingering effect.
Release 5 — day 28, dose 2
Symptoms: Motor control in my legs had reemerged. It as if my legs disappeared and collapsed to the ground. I was able to get up. Also, my stuttering is back.
Healthcare visit (other): Appointment with Neurologist
Release 6 — day 35, dose 2
Symptoms: Back pain. I have had back problems in the past, nut since I received my pfizer shot, my back has gotten an order of magnitude worse. Who knows if there is a correlation or not. But something changed.
Healthcare visit (other): See a pain doctor
Release 6 — day 42, dose 2
Symptoms: Still have a fair amount of loss of muscle control.
Healthcare visit (other): Neurologist
Release 11 — day 14, dose 4
Symptoms: I vomited the morning after. Nausea stayed with me for only about 30 minutes
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 | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Ataxia | ✓ | ✓ | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release