4HT-26102-22369
2 vaccinations
2 coded responses
7 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 292 / SC
- Registered
- 2021-01-25
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
-
2021-01-18
Dose 1 — Pfizer-BioNTech
-
2021-01-25
Registered in v-safe
- 2021-01-25
-
2021-02-01
Survey response — day 14, dose 1MedDRA: Abdominal pain, Diverticulitis, Pre-existing disease — Feeling: Good · Be unable to work, Be unable to do your normal daily activitiesFree text: Diverticulitis flare up caused intense abdominal pain, lower left quadrant, for 2.5 days. No fever. Prior bouts began 2002. Normal stool. Pre-existing, recurrenf ailment not believed to be related to vaccine. Over weekend.JBSMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-08
Dose 2 — Pfizer-BioNTech
-
2021-02-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-11
- 2021-03-22
- 2021-08-11
-
2022-02-10
Survey response — 12 months, dose 2MedDRA: COVID-19, Hospitalisation, Pneumonia, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, HospitalizationFree text: Admitted to hospital with bilateral pneumonia on 1/31/21. Stayed 12 days untl 1/11/2022. Negative for Covid upon admission. But pulmonary specialist said I had Covid at post hospitalization exam on or about February 1st.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-10
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-02-14
- 2022-02-17
-
2022-02-17
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-18 | Pfizer-BioNTech | |
| 2 | 2021-02-08 | Pfizer-BioNTech |
Call center
1 call center case
1 successful
Free text
Release 3 — day 14, dose 1
Symptoms: Diverticulitis flare up caused intense abdominal pain, lower left quadrant, for 2.5 days. No fever. Prior bouts began 2002. Normal stool. Pre-existing, recurrenf ailment not believed to be related to vaccine. Over weekend.JBS
Release 11 — 12 months, dose 2
Symptoms: Admitted to hospital with bilateral pneumonia on 1/31/21. Stayed 12 days untl 1/11/2022. Negative for Covid upon admission. But pulmonary specialist said I had Covid at post hospitalization exam on or about February 1st.
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 | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diverticulitis | ✓ | ✓ | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release