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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

  1. 2021-07-13
    Dose 1 — Pfizer-BioNTech
  2. 2021-07-14
    Registered in v-safe
  3. 2021-07-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dry mouth — Feeling: Good · Site: Pain · Headache
    Free text: Cotton mouth and dry mouth.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-07-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-07-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-07-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-07-18
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dyspnoea — Feeling: Fair · Fever
    Free text: Sudden moments where I feel like I can't catch my breath
    MedDRA releases: 2024-11 · check-in free text available
  8. 2021-07-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-07-20
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-07-27
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-08-26
    Survey response — day 42, dose 1
    MedDRA: Arthralgia, Chest pain, Injection site pain, Loss of consciousness, Pain, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activities
    Free 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 contin
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  12. 2021-10-12
    Survey response — 3 months, dose 1
    MedDRA: Arthralgia, Catarrh, Chest pain, Dyspnoea, Headache, Pain, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities
    Free 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 headaches
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-07-13Pfizer-BioNTech No

Free text

Release 9 — days 1–6 daily, dose 1

2021-07-14

Systemic reaction (other): Cotton mouth and dry mouth.

2021-07-18

Systemic reaction (other): Sudden moments where I feel like I can't catch my breath

Release 9 — day 42, dose 1

2021-08-26

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

2021-10-12

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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ · ✓
SDCatarrh · · ✓
SDChest pain ✓ · ✓
SDDyspnoea · · ✓
SDHeadache · · ✓
SDInjection site pain ✓ · ✓
SDLoss of consciousness ✓ · ✓
SDPain ✓ · ✓
SDPain in extremity ✓ · ✓
SRODry mouth ✓ ✓ ✓
SRODyspnoea · · ✓

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