4FD-11250-09789
2 vaccinations
7 coded responses
23 check-ins
7 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 028 / RI
- Registered
- 2021-03-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-06
Registered in v-safe
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2021-03-06
Dose 1 — Pfizer-BioNTech
- 2021-03-06
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2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus — Feeling: Good · Site: PainFree text: My arms get itchy in small areas for short amounts of time. Maybe 3-4 times in 24 hours.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Sluggishness — Feeling: Fair · Site: Pain · Fever · Nausea · Be unable to workFree text: A little sluggish and dizzy this morning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-09
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Feeling abnormal — Feeling: Fair · Fatigue or tiredness, NauseaFree text: Feeling spacy and dizzy - mostly in the morning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-20
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2021-03-27
Survey response — day 21, dose 1MedDRA: Abdominal pain upper, Decreased appetite, Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: This week my stomach was a little painful, and I wasn't as hungry, and I had mild headaches in and off.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-28
Dose 2 — Pfizer-BioNTech
- 2021-03-28
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2021-03-29
Survey response — days 1–6 daily, dose 2MedDRA: Self-medication — Feeling: Good · Site: PainFree text: I took some acetaminophen today, and have felt good all day so far.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-30
Survey response — days 1–6 daily, dose 2MedDRA: Feeling jittery — Feeling: Good · Site: Pain · Fever · Joint painsFree text: I felt jittery today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-31
- 2021-04-03
- 2021-04-04
- 2021-04-11
- 2021-04-18
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2021-04-25
Survey response — day 28, dose 2MedDRA: Arthralgia, Myalgia, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Week-long pain in R arm - in the forearm, elbow, and bicep area. It's worse when the elbow is bent for a time. This is not a regular ache or pain for me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-02
- 2021-05-09
- 2021-09-26
- 2022-03-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-06 | Pfizer-BioNTech | |
| 2 | 2021-03-28 | Pfizer-BioNTech |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): My arms get itchy in small areas for short amounts of time. Maybe 3-4 times in 24 hours.
Systemic reaction (other): A little sluggish and dizzy this morning.
Systemic reaction (other): Feeling spacy and dizzy - mostly in the morning.
Release 6 — day 21, dose 1
Symptoms: This week my stomach was a little painful, and I wasn't as hungry, and I had mild headaches in and off.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): I took some acetaminophen today, and have felt good all day so far.
Systemic reaction (other): I felt jittery today.
Release 7 — day 28, dose 2
Symptoms: Week-long pain in R arm - in the forearm, elbow, and bicep area. It's worse when the elbow is bent for a time. This is not a regular ache or pain for me.
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 | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Decreased appetite | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Feeling jittery | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Sluggishness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release