4FL-19555-34900
4 vaccinations
7 coded responses
19 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 762 / TX
- Registered
- 2021-10-24
- Relationship
- Adult relative or friend
- Guardian
- 9VX-30018-14011
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-09
Dose 1 — Pfizer-BioNTech
-
2021-03-30
Dose 2 — Pfizer-BioNTech
-
2021-10-23
Dose 3 — Pfizer-BioNTech
-
2021-10-24
Registered in v-safe
-
2021-10-24
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Feeling abnormal, Mental impairment, Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Has Parkinson's and has been very 'out of it' not able to think straight like when he got his second dose.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-25
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Parkinson's cognitive issues severe and worsened after getting booster.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-27
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Cognitive disorder — Feeling: Good · Site: Pain, Swelling, Itching · Abdominal painFree text: Cognitive has improved closer to pd baselineMedDRA releases: 2024-11 · check-in free text available
-
2021-10-28
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Cognitive disorder — Feeling: Good · NauseaFree text: Cognitive much improvedMedDRA releases: 2024-11 · check-in free text available
- 2021-10-29
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-27
- 2022-01-22
- 2022-04-25
-
2022-06-17
Dose 4 — Pfizer-BioNTech
-
2022-06-18
Survey response — days 1–6 daily, dose 4, dependentMedDRA: Dementia, Insomnia, Pre-existing disease — Feeling: Poor · Site: Pain · Fever · Be unable to do your normal daily activitiesFree text: Dementia severely worsened. Didn't sleep at all. Up all night.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-20
Survey response — days 1–6 daily, dose 4, dependentMedDRA: Cognitive disorder — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Still a little off cognitivelyMedDRA releases: 2024-11 · check-in free text available
- 2022-06-24
- 2022-07-17
-
2022-07-24
Survey response — day 35, dose 4, dependentMedDRA: Cough, Hospitalisation, Oxygen saturation decreased, SARS-CoV-2 test negative — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Had cough, low blood oxygen level and admitted to hospital. Tested prior twice tor COVID and once with pcr for admittance. All showed negative resultMedDRA releases: 2024-11 · check-in free text available
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2022-07-24
Report sent to call center — day 35, dose 4, dependentGet care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-07-25
-
2022-07-25
Call successfulCompleted over the phone
- 2022-07-29
- 2022-12-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-09 | Pfizer-BioNTech | No |
| 2 | 2021-03-30 | Pfizer-BioNTech | No |
| 3 | 2021-10-23 | Pfizer-BioNTech | No |
| 4 | 2022-06-17 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 10 — days 1–6 daily, dose 3, dependent
Systemic reaction (other): Has Parkinson's and has been very 'out of it' not able to think straight like when he got his second dose.
Systemic reaction (other): Parkinson's cognitive issues severe and worsened after getting booster.
Systemic reaction (other): Cognitive has improved closer to pd baseline
Systemic reaction (other): Cognitive much improved
Release 12 — days 1–6 daily, dose 4, dependent
Systemic reaction (other): Dementia severely worsened. Didn't sleep at all. Up all night.
Systemic reaction (other): Still a little off cognitively
Release 12 — day 35, dose 4, dependent
Symptoms: Had cough, low blood oxygen level and admitted to hospital. Tested prior twice tor COVID and once with pcr for admittance. All showed negative result
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 | Cough | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Oxygen saturation decreased | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Cognitive disorder | · | · | ✓ |
| SRO | Condition aggravated | · | · | ✓ |
| SRO | Dementia | · | · | ✓ |
| SRO | Feeling abnormal | · | · | ✓ |
| SRO | Insomnia | · | · | ✓ |
| SRO | Mental impairment | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release