4E5-16180-41345
5 vaccinations
6 coded responses
46 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 553 / MN
- Registered
- 2021-03-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Dose 1 — Pfizer-BioNTech
-
2021-03-28
Registered in v-safe
-
2021-03-28
Survey response — day 7, dose 1MedDRA: Pre-existing disease — Feeling: GoodFree text: I have chronic nasal allergies and take daily meditations for those.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-02
Survey response — day 14, dose 1MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesFree text: A flare up of diverticulitis that I have had for years.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-07
Dose 2 — Pfizer-BioNTech
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-10
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-21
- 2021-04-30
- 2021-05-07
- 2021-05-12
- 2021-05-21
- 2021-07-09
-
2021-10-08
Survey response — 6 months, dose 2MedDRA: Cough, Fatigue — Feeling: Good · Be unable to do your normal daily activitiesFree text: persistent dry cough and fatigueMedDRA releases: 2024-11 · check-in free text available
-
2021-12-16
Dose 3 — Moderna
-
2021-12-17
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
-
2021-12-18
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-12-19
- 2021-12-20
-
2021-12-25
Survey response — day 7, dose 3MedDRA: Upper respiratory tract infection — Feeling: Fair · Fatigue or tirednessFree text: I have some kind of upper respiratory infection, which began just after my booster shot side effects subsided.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-01
Survey response — day 14, dose 3MedDRA: Headache, Nasal congestion, Nausea, Pain — Feeling: Poor · Be unable to do your normal daily activitiesFree text: headache, body aches, nasal congestion, and nauseaMedDRA releases: 2024-11 · check-in free text available
- 2022-01-08
- 2022-01-15
- 2022-01-22
- 2022-01-27
- 2022-03-19
-
2022-04-22
Dose 4 — Pfizer-BioNTech
- 2022-04-22
-
2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-04-24
- 2022-04-25
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-07-22
-
2022-09-21
Dose 5 — Pfizer-BioNTechCo-administered: Flu
- 2022-09-29
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-11-02
-
2022-12-21
Survey response — 3 months, dose 5MedDRA: Appendicitis, Laparoscopic surgery — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: I had uncomplicated appendicitis that was successfully treated by laparoscopic surgery.MedDRA releases: 2024-11 · check-in free text available
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2022-12-21
Report sent to call center — 3 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
-
2022-12-22
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-03-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Pfizer-BioNTech | |
| 2 | 2021-04-07 | Pfizer-BioNTech | |
| 3 | 2021-12-16 | Moderna | No |
| 4 | 2022-04-22 | Pfizer-BioNTech | No |
| 5 | 2022-09-21 | Pfizer-BioNTech | Flu |
Call center
1 call center case
1 successful
Free text
Release 6 — day 7, dose 1
Systemic reaction (other): I have chronic nasal allergies and take daily meditations for those.
Release 6 — day 14, dose 1
Symptoms: A flare up of diverticulitis that I have had for years.
Release 10 — 6 months, dose 2
Symptoms: persistent dry cough and fatigue
Release 10 — day 7, dose 3
Systemic reaction (other): I have some kind of upper respiratory infection, which began just after my booster shot side effects subsided.
Release 10 — day 14, dose 3
Symptoms: headache, body aches, nasal congestion, and nausea
Release 12 — 3 months, dose 5
Symptoms: I had uncomplicated appendicitis that was successfully treated by laparoscopic surgery.
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 | Appendicitis | · | · | ✓ |
| SD | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Laparoscopic surgery | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Upper respiratory tract infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release