4J8-30251-44129
3 vaccinations
4 coded responses
16 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 117 / NY
- Registered
- 2021-01-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-07
Registered in v-safe
-
2021-01-07
Dose 1 — Pfizer-BioNTech
-
2021-01-07
Survey response — day 0, dose 1MedDRA: Dry eye, Dry mouth, Headache — Feeling: Good · Site: PainFree text: Slight dry mouth & dry eyes. Slight headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-08
Survey response — days 1–6 daily, dose 1MedDRA: Dry eye — Feeling: Good · Fatigue or tirednessFree text: Dry eyesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-09
- 2021-01-10
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-21
- 2021-01-28
-
2021-01-29
Dose 2 — Pfizer-BioNTech
-
2021-02-23
Survey response — day 21, dose 2MedDRA: Herpes simplex, Pre-existing disease, Vaccine positive rechallenge — Feeling: Good · Be unable to do your normal daily activitiesFree text: I had a herpes outbreak after both shots. Did not mention it the first time but then when i had another episode 3 weeks later, days after the shot, I thought that it must be from the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-26
Survey response — day 28, dose 2MedDRA: Bone pain, Dizziness, Headache, Loss of consciousness, Myalgia, Nausea — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I had my #2 shingles vaccine on Wed. 3 weeks,5 days after #2COVID vaccine(as recommended) i was knocked off my feet by this,deep muscle/bone pain, headache,dizzy, nauseous. I actually blacked out and regained conciseness in 5 min w/split lip bruisesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-14
- 2021-04-30
- 2021-07-30
-
2021-10-24
Dose 3 — Pfizer-BioNTech
- 2022-04-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Pfizer-BioNTech | |
| 2 | 2021-01-29 | Pfizer-BioNTech | |
| 3 | 2021-10-24 | Pfizer-BioNTech | No |
Free text
Release 1 — day 0, dose 1
Systemic reaction (other): Slight dry mouth & dry eyes. Slight headache
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Dry eyes
Release 4 — day 21, dose 2
Symptoms: I had a herpes outbreak after both shots. Did not mention it the first time but then when i had another episode 3 weeks later, days after the shot, I thought that it must be from the vaccine.
Release 4 — day 28, dose 2
Symptoms: I had my #2 shingles vaccine on Wed. 3 weeks,5 days after #2COVID vaccine(as recommended) i was knocked off my feet by this,deep muscle/bone pain, headache,dizzy, nauseous. I actually blacked out and regained conciseness in 5 min w/split lip bruises cut off by CDC
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 | Bone pain | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Herpes simplex | ✓ | ✓ | ✓ |
| SD | Loss of consciousness | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Vaccine positive rechallenge | ✓ | ✓ | ✓ |
| SRO | Dry eye | ✓ | ✓ | ✓ |
| SRO | Dry mouth | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release