4JM-11168-03686
4 vaccinations
9 coded responses
46 check-ins
8 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 117 / NY
- Registered
- 2021-04-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-23
Dose 1 — Pfizer-BioNTech
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2021-04-05
Registered in v-safe
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2021-04-05
Survey response — day 7, dose 1MedDRA: Fatigue, Injection site pain — Feeling: GoodFree text: had pain at injection site for 48 hours after shot but otherwise fine. From 48-96 hours after shot, felt fatigue. After that, fine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
-
2021-04-13
Dose 2 — Pfizer-BioNTech
- 2021-04-13
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2021-04-14
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Pain and swelling in left armpitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
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2021-04-17
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-18
- 2021-04-19
- 2021-04-21
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-07-18
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2021-10-12
Survey response — 6 months, dose 2MedDRA: Fatigue, Iron deficiency — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Moderate fatigue 2-3 days per week - likely iron deficiency & not vaccine relatedMedDRA releases: 2024-11 · check-in free text available
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2021-10-12
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-19
- 2021-10-22
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2021-10-29
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2021-11-14
Dose 3 — Moderna
- 2021-11-14
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2021-11-15
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-11-16
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-18
- 2021-11-19
- 2021-11-20
- 2021-11-21
- 2021-11-28
- 2021-12-05
- 2021-12-12
- 2021-12-19
- 2021-12-26
- 2022-02-13
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2022-05-01
Dose 4 — Moderna
- 2022-05-01
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2022-05-02
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-05-03
Survey response — days 1–6 daily, dose 4MedDRA: Insomnia — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: Difficulty sleeping (last night and night before)MedDRA releases: 2024-11 · check-in free text available
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2022-05-04
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-05-05
- 2022-05-06
- 2022-05-07
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2022-05-08
Survey response — day 7, dose 4MedDRA: Insomnia — Feeling: Good · Muscle or body achesFree text: Difficulty sleepingMedDRA releases: 2024-11 · check-in free text available
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2022-05-15
Survey response — day 14, dose 4MedDRA: Cough, Fatigue, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Had a cold 5/10-15: sore throat, coughing, stuffy head, runny nose, fatigue. Had two negative Covid rapid tests.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-22
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2022-05-29
Survey response — day 28, dose 4MedDRA: Fatigue, Lymph node pain, Throat irritation — Feeling: Good · Be unable to do your normal daily activitiesFree text: Friday 5/27 very mild scratchy throat and sore glands in neck. Saturday 5/28 those symptoms gone but intense fatigue. Today 529 no symptomsMedDRA releases: 2024-11 · check-in free text available
- 2022-06-05
- 2022-06-12
- 2022-07-31
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2022-11-02
Survey response — 6 months, dose 4MedDRA: Food poisoning, Gastroenteritis viral, Nerve compression, Pain in extremity — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Had food poisoning a week ago and terrible stomach virus yesterday. Have had a pinched nerve in my neck and resulting intense L arm pain for 2 months.MedDRA releases: 2024-11 · check-in free text available
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2023-05-03
Survey response — 12 months, dose 4MedDRA: Periarthritis, Tendon disorder — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-05-03
Report sent to call center — 12 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-05-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-23 | Pfizer-BioNTech | |
| 2 | 2021-04-13 | Pfizer-BioNTech | |
| 3 | 2021-11-14 | Moderna | No |
| 4 | 2022-05-01 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 6 — day 7, dose 1
Systemic reaction (other): had pain at injection site for 48 hours after shot but otherwise fine. From 48-96 hours after shot, felt fatigue. After that, fine.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Pain and swelling in left armpit
Release 10 — 6 months, dose 2
Symptoms: Moderate fatigue 2-3 days per week - likely iron deficiency & not vaccine related
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Difficulty sleeping (last night and night before)
Release 11 — day 7, dose 4
Systemic reaction (other): Difficulty sleeping
Release 11 — day 14, dose 4
Symptoms: Had a cold 5/10-15: sore throat, coughing, stuffy head, runny nose, fatigue. Had two negative Covid rapid tests.
Release 11 — day 28, dose 4
Symptoms: Friday 5/27 very mild scratchy throat and sore glands in neck. Saturday 5/28 those symptoms gone but intense fatigue. Today 529 no symptoms
Release 12 — 6 months, dose 4
Symptoms: Had food poisoning a week ago and terrible stomach virus yesterday. Have had a pinched nerve in my neck and resulting intense L arm pain for 2 months.
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 | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Food poisoning | · | · | ✓ |
| SD | Gastroenteritis viral | · | · | ✓ |
| SD | Iron deficiency | · | · | ✓ |
| SD | Lymph node pain | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Nerve compression | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Periarthritis | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Tendon disorder | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Insomnia | · | · | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release