4GX-53977-80414
4 vaccinations
9 coded responses
38 check-ins
9 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 920 / CA
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-17
Dose 1 — Pfizer-BioNTech
-
2021-03-10
Dose 2 — Pfizer-BioNTech
-
2021-03-11
Registered in v-safe
- 2021-03-11
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-04-21
- 2021-06-09
- 2021-09-08
-
2021-10-08
Dose 3 — Pfizer-BioNTech
-
2021-10-13
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Itching · Abdominal painAdult check-in
- 2021-10-14
- 2021-10-15
-
2021-10-22
Survey response — day 14, dose 3MedDRA: Diarrhoea — Feeling: FairFree text: 1 hr diarreaMedDRA releases: 2024-11 · check-in free text available
-
2021-10-29
Survey response — day 21, dose 3MedDRA: Flatulence — Feeling: FairFree text: GasMedDRA releases: 2024-11 · check-in free text available
- 2021-11-05
-
2021-11-12
Survey response — day 35, dose 3MedDRA: Pre-existing disease, Rhinorrhoea — Feeling: GoodFree text: Sinus alergies causing runny nose probably from the beautiful dry weather here in San Diego. Feel good otherwise. Apettite good. Energy good.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-20
-
2022-01-07
Survey response — 3 months, dose 3MedDRA: Diverticulitis — Feeling: Good · Be unable to do your normal daily activitiesFree text: Had gut Divirticolitus for two days two weeks ago. Fasted for 3 days to resolve.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-09
Survey response — 6 months, dose 3MedDRA: Back pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: For four days now I have back pain in lower left, as if a kidney stone. May be from starting a new excersize regimem.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-14
Dose 4 — Pfizer-BioNTech
- 2022-04-14
-
2022-04-15
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, DiarrheaAdult check-in
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-23
-
2022-04-28
Survey response — day 14, dose 4MedDRA: Cough, Fatigue, Nasopharyngitis, Oropharyngeal pain, Paranasal sinus hypersecretion, SARS-CoV-2 test negative — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sore throat. Head cold. Tired. Draining sinus. Cough. Took a Home Covid Test at home and it was negative.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-05
Survey response — day 21, dose 4MedDRA: Cough, Headache, Lower respiratory tract infection, Self-medication — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Chest cold, deep cough, headache. Doctor put me on antibiotics. And I've been taking Claritin-D.MedDRA releases: 2024-11 · check-in free text available
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2022-05-05
Report sent to call center — day 21, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-06
- 2022-05-14
- 2022-05-22
-
2022-05-28
Survey response — day 42, dose 4MedDRA: Circadian rhythm sleep disorder, Fatigue — Feeling: FairFree text: Tiredness. Probably due to 8 hr jet lag due to travel to/from (b)(6).MedDRA releases: 2024-11 · check-in free text available
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2022-07-14
Survey response — 3 months, dose 4MedDRA: Fatigue, Oropharyngeal pain — Feeling: FairFree text: Tired and sore throat for two days.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-17 | Pfizer-BioNTech | |
| 2 | 2021-03-10 | Pfizer-BioNTech | |
| 3 | 2021-10-08 | Pfizer-BioNTech | No |
| 4 | 2022-04-14 | Pfizer-BioNTech | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 10 — day 14, dose 3
Symptoms: 1 hr diarrea
Release 10 — day 21, dose 3
Symptoms: Gas
Release 10 — day 35, dose 3
Symptoms: Sinus alergies causing runny nose probably from the beautiful dry weather here in San Diego. Feel good otherwise. Apettite good. Energy good.
Release 10 — 3 months, dose 3
Symptoms: Had gut Divirticolitus for two days two weeks ago. Fasted for 3 days to resolve.
Release 11 — 6 months, dose 3
Symptoms: For four days now I have back pain in lower left, as if a kidney stone. May be from starting a new excersize regimem.
Release 11 — day 14, dose 4
Symptoms: Sore throat. Head cold. Tired. Draining sinus. Cough. Took a Home Covid Test at home and it was negative.
Release 11 — day 21, dose 4
Symptoms: Chest cold, deep cough, headache. Doctor put me on antibiotics. And I've been taking Claritin-D.
Release 11 — day 42, dose 4
Symptoms: Tiredness. Probably due to 8 hr jet lag due to travel to/from (b)(6).
redacted (b)(6)
Release 12 — 3 months, dose 4
Symptoms: Tired and sore throat for two days.
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 | Back pain | · | · | ✓ |
| SD | Circadian rhythm sleep disorder | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Diverticulitis | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Flatulence | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Lower respiratory tract infection | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release