4J9-15052-06811
1 vaccination
5 coded responses
15 check-ins
5 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 847 / UT
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Pfizer-BioNTech
- 2021-01-15
-
2021-01-16
Survey response — days 1–6 daily, dose 1MedDRA: Limb discomfort — Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: My arm was slightly stiffMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-16
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-22
-
2021-01-29
Survey response — day 14, dose 1MedDRA: Cough, Headache, Nasopharyngitis, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I feel like I have a cold. cough chest congestion and bad headache, but I dont think its related to the vaccine. My wife has the same symptoms and she did not receive the vaccine. I just think we picked up a cold somewhere. We dont have fevMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-05
Survey response — day 21, dose 1MedDRA: Airway complication of anaesthesia, Malaise, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Ten days after my first shot, I developed COVID symptoms (Jan25th). I thought my wife and I had colds but we werent getting better. After 8 days we requested COVID tests by Intermountain Health. The saliva PCR test was POSITIVE for both of us.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Survey response — day 28, dose 1MedDRA: Arthralgia, Myalgia — Feeling: GoodFree text: The muscle near my left knee is sore and when I kneel on it, it feels like needles are poking inside itMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
- 2021-02-26
- 2021-04-17
- 2021-07-16
-
2022-01-15
Survey response — 12 months, dose 1MedDRA: Blood pressure abnormal, Cardiac murmur, Emergency care, Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Heart palpitations. Erratic blood pressure occasionally. I went to the ER for my BP and the Dr who examine me heart a slight heart Murmur. I have never been told that I had any sort of heart issues in the past. I am a hey to see a CardiologistMedDRA releases: 2024-11 · check-in free text available
-
2022-01-15
Report sent to call center — 12 months, dose 1Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-01-17
-
2022-01-20
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Pfizer-BioNTech |
Call center
2 call center cases
1 successful · 1 priority 2/3 (triaged and no follow up)
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): My arm was slightly stiff
Release 3 — day 14, dose 1
Symptoms: I feel like I have a cold. cough chest congestion and bad headache, but I dont think its related to the vaccine. My wife has the same symptoms and she did not receive the vaccine. I just think we picked up a cold somewhere. We dont have fev
Release 3 — day 21, dose 1
Symptoms: Ten days after my first shot, I developed COVID symptoms (Jan25th). I thought my wife and I had colds but we werent getting better. After 8 days we requested COVID tests by Intermountain Health. The saliva PCR test was POSITIVE for both of us.
Release 4 — day 28, dose 1
Symptoms: The muscle near my left knee is sore and when I kneel on it, it feels like needles are poking inside it
Release 10 — 12 months, dose 1
Symptoms: Heart palpitations. Erratic blood pressure occasionally. I went to the ER for my BP and the Dr who examine me heart a slight heart Murmur. I have never been told that I had any sort of heart issues in the past. I am a hey to see a Cardiologist
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 | Airway complication of anaesthesia | ○ | ✓ | ○ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Blood pressure abnormal | · | · | ✓ |
| SD | Cardiac murmur | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Malaise | ✓ | · | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | ✓ | ✓ | ✓ |
| SRO | Limb discomfort | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release