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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

  1. 2021-01-15
    Registered in v-safe
  2. 2021-01-15
    Dose 1 — Pfizer-BioNTech
  3. 2021-01-15
    Health check-in — day 0, dose 1
    Feeling: Fair · Headache
    Adult check-in
  4. 2021-01-16
    Survey response — days 1–6 daily, dose 1
    MedDRA: Limb discomfort — Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: My arm was slightly stiff
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-16
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to do your normal daily activities
    1 call case(s)
  6. 2021-01-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  7. 2021-01-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-22
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-01-29
    Survey response — day 14, dose 1
    MedDRA: Cough, Headache, Nasopharyngitis, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities
    Free 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 fev
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-05
    Survey response — day 21, dose 1
    MedDRA: Airway complication of anaesthesia, Malaise, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities
    Free 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
  13. 2021-02-12
    Survey response — day 28, dose 1
    MedDRA: Arthralgia, Myalgia — Feeling: Good
    Free text: The muscle near my left knee is sore and when I kneel on it, it feels like needles are poking inside it
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-02-19
    Health check-in — day 35, dose 1
    Feeling: Good
    Adult check-in
  15. 2021-02-26
    Health check-in — day 42, dose 1
    Feeling: Fair
    Adult check-in
  16. 2021-04-17
    Health check-in — 3 months, dose 1
    Feeling: Good
    Adult check-in
  17. 2021-07-16
    Health check-in — 6 months, dose 1
    Feeling: Good
    Adult check-in
  18. 2022-01-15
    Survey response — 12 months, dose 1
    MedDRA: Blood pressure abnormal, Cardiac murmur, Emergency care, Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free 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 Cardiologist
    MedDRA releases: 2024-11 · check-in free text available
  19. 2022-01-15
    Report sent to call center — 12 months, dose 1
    Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · 1 call case(s)
  20. 2022-01-17
  21. 2022-01-20
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-01-15Pfizer-BioNTech

Call center

2 call center cases

1 successful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-16

Systemic reaction (other): My arm was slightly stiff

Release 3 — day 14, dose 1

2021-01-29

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

2021-02-05

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

2021-02-12

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

2022-01-15

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

FieldPreferred term2021-092023-042024-11
SDAirway complication of anaesthesia ○ ✓ ○
SDArthralgia ✓ ✓ ✓
SDBlood pressure abnormal · · ✓
SDCardiac murmur · · ✓
SDCough ✓ ✓ ✓
SDEmergency care · · ✓
SDHeadache ✓ ✓ ✓
SDMalaise ✓ · ✓
SDMyalgia ✓ ✓ ✓
SDNasopharyngitis ✓ ✓ ✓
SDPalpitations · · ✓
SDRespiratory tract congestion ✓ ✓ ✓
SDSARS-CoV-2 test positive ✓ ✓ ✓
SROLimb discomfort ✓ ✓ ✓

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