4GK-81075-17305
1 vaccination
4 coded responses
10 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 956 / CA
- Registered
- 2021-07-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-07-13
Dose 1 — Pfizer-BioNTech
-
2021-07-14
Registered in v-safe
-
2021-07-14
Survey response — days 1–6 daily, dose 1MedDRA: Dry mouth — Feeling: Good · Site: Pain · HeadacheFree text: Cotton mouth and dry mouth.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-15
- 2021-07-16
- 2021-07-17
-
2021-07-18
Survey response — days 1–6 daily, dose 1MedDRA: Dyspnoea — Feeling: Fair · FeverFree text: Sudden moments where I feel like I can't catch my breathMedDRA releases: 2024-11 · check-in free text available
- 2021-07-19
- 2021-07-20
- 2021-07-27
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2021-08-26
Survey response — day 42, dose 1MedDRA: Arthralgia, Chest pain, Injection site pain, Loss of consciousness, Pain, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Increasing amount of pain where I got the shot and it generates this way all the way down to my fingertips and then an travels up my shoulder to the middle of my chest like I'm ready to have a heart attack I passed out and I woke up this still continMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-12
Survey response — 3 months, dose 1MedDRA: Arthralgia, Catarrh, Chest pain, Dyspnoea, Headache, Pain, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Trouble breathing from The Continuous mucus buildup no infection at least once a week extreme pain in my left arm traveling from my shoulder to my fingertips from my shoulder to the left side of my chest frequent headachesMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-07-13 | Pfizer-BioNTech | No |
Free text
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Cotton mouth and dry mouth.
Systemic reaction (other): Sudden moments where I feel like I can't catch my breath
Release 9 — day 42, dose 1
Symptoms: Increasing amount of pain where I got the shot and it generates this way all the way down to my fingertips and then an travels up my shoulder to the middle of my chest like I'm ready to have a heart attack I passed out and I woke up this still contin cut off by CDC
Release 10 — 3 months, dose 1
Symptoms: Trouble breathing from The Continuous mucus buildup no infection at least once a week extreme pain in my left arm traveling from my shoulder to my fingertips from my shoulder to the left side of my chest frequent headaches
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 | Arthralgia | ✓ | · | ✓ |
| SD | Catarrh | · | · | ✓ |
| SD | Chest pain | ✓ | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site pain | ✓ | · | ✓ |
| SD | Loss of consciousness | ✓ | · | ✓ |
| SD | Pain | ✓ | · | ✓ |
| SD | Pain in extremity | ✓ | · | ✓ |
| SRO | Dry mouth | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release