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4CW-16753-36932

3 vaccinations 6 coded responses 16 check-ins 6 free-text entries 1 call case
Sex
Male
Age at first dose
66+
ZIP prefix
980 / WA
Registered
2021-03-15
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-13
    Dose 1 — Pfizer-BioNTech
  2. 2021-03-15
    Registered in v-safe
  3. 2021-03-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Headache
    Adult check-in
  4. 2021-03-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-03-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-18
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dyspnoea — Feeling: Fair
    Free text: Out of breath.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-19
    Survey response — days 1–6 daily, dose 1
    MedDRA: Abdominal pain upper, Cough, Insomnia — Feeling: Fair
    Free text: Coughing, stomach ache. Didn't sleep til 5am this morning.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-20
    Survey response — day 7, dose 1
    MedDRA: Dyspnoea, Insomnia — Feeling: Fair
    Free text: Having problems sleeping. Hard to breath.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-27
    Health check-in — day 14, dose 1
    Feeling: Fair
    Adult check-in
  10. 2021-04-03
    Survey response — day 21, dose 1
    MedDRA: Dyspnoea — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Harder time breathing. I am still ambulatory, but using the inhaler a LOT more.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-10
    Survey response — day 28, dose 1
    MedDRA: Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Received, prednisone, azithromycin and working on getting oxygen thru my doc.As a result, second Covid shot will be two weeks AFTER the last of the meds above are done. Roughly, 2nd week of May.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-10
    Report sent to call center — day 28, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-04-17
    Survey response — day 35, dose 1
    MedDRA: Office visit — Feeling: Good
    Free text: Dr. gave me oxygen and it was WONDERFUL! My insurance covered it. It is a God Send!!I NEED MY SECOND Pfieser Covid 19 in two weeks from now. Help!
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-24
    Health check-in — day 42, dose 1
    Feeling: Good
    Adult check-in
  15. 2021-05-03
    Dose 2 — Pfizer-BioNTech
  16. 2021-06-12
    Health check-in — 3 months, dose 1
    Feeling: Good
    Adult check-in
  17. 2021-06-12
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-06-14
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-09-08
    Dose 3 — Pfizer-BioNTech
  20. 2021-12-08
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  21. 2022-02-10
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  22. 2022-03-09
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-13Pfizer-BioNTech
22021-05-03Pfizer-BioNTech
32021-09-08Pfizer-BioNTech No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-18

Systemic reaction (other): Out of breath.

2021-03-19

Systemic reaction (other): Coughing, stomach ache. Didn't sleep til 5am this morning.

Release 6 — day 7, dose 1

2021-03-20

Systemic reaction (other): Having problems sleeping. Hard to breath.

Release 6 — day 21, dose 1

2021-04-03

Symptoms: Harder time breathing. I am still ambulatory, but using the inhaler a LOT more.

Release 7 — day 28, dose 1

2021-04-10

Symptoms: Received, prednisone, azithromycin and working on getting oxygen thru my doc.As a result, second Covid shot will be two weeks AFTER the last of the meds above are done. Roughly, 2nd week of May.

Release 7 — day 35, dose 1

2021-04-17

Symptoms: Dr. gave me oxygen and it was WONDERFUL! My insurance covered it. It is a God Send!!I NEED MY SECOND Pfieser Covid 19 in two weeks from now. Help!

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

FieldPreferred term2021-092023-042024-11
SDDyspnoea ✓ ✓ ✓
SDOffice visit ✓ ✓ ✓
SDUnevaluable event ✓ ✓ ✓
SROAbdominal pain upper ✓ ✓ ✓
SROCough ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓
SROInsomnia ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release