4JP-20521-10463
2 vaccinations
5 coded responses
12 check-ins
5 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 630 / MO
- Registered
- 2021-04-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-18
Dose 1 — Pfizer-BioNTech
-
2021-04-08
Registered in v-safe
-
2021-04-08
Dose 2 — Pfizer-BioNTech
- 2021-04-08
-
2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Pain in extremity — Feeling: Good · Muscle or body achesFree text: Just a little sore in the arm generally yesterday and today but not severe pain and not localized at vaccine spotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-11
- 2021-04-14
-
2021-04-22
Survey response — day 14, dose 2MedDRA: Cough, Hypersensitivity, Lacrimation increased, Pre-existing disease, Rhinorrhoea, Sneezing, Somnolence, Upper-airway cough syndrome — Feeling: FairFree text: probably allergies, NO FEVER, but getting runny nose, post-nasal drip-induced cough and sneezing/watery eyes, general drowsy feel like my body is fighting off the allergenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-29
- 2021-05-10
- 2021-05-15
- 2021-05-20
-
2021-07-08
Survey response — 3 months, dose 2MedDRA: Ankle fracture, Ankle operation, Joint stabilisation — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Health condition: broke my ankle, just had surgery to install stabilizationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-08
Report sent to call center — 3 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 pr1 call case(s)
-
2021-07-13
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-10-07
Survey response — 6 months, dose 2MedDRA: Dyspepsia, Dyspnoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: indigestion issues that manifest as shortness of breath at night, possibly sleep apnia.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-07
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2021-10-08
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-04-08
Survey response — 12 months, dose 2MedDRA: Unevaluable event, Vaginal polyp — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Polyp in vaginal area · Healthcare visit (other): UltrasoundMedDRA releases: 2024-11 · check-in free text available
-
2022-04-08
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-13
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Pfizer-BioNTech | |
| 2 | 2021-04-08 | Pfizer-BioNTech |
Call center
3 call center cases
3 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Just a little sore in the arm generally yesterday and today but not severe pain and not localized at vaccine spot
Release 7 — day 14, dose 2
Symptoms: probably allergies, NO FEVER, but getting runny nose, post-nasal drip-induced cough and sneezing/watery eyes, general drowsy feel like my body is fighting off the allergen
Release 9 — 3 months, dose 2
Symptoms: Health condition: broke my ankle, just had surgery to install stabilization
Release 10 — 6 months, dose 2
Symptoms: indigestion issues that manifest as shortness of breath at night, possibly sleep apnia.
Release 11 — 12 months, dose 2
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 |
|---|---|---|---|---|
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Ankle fracture | ✓ | ✓ | ✓ |
| SD | Ankle operation | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Dyspepsia | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Hypersensitivity | ○ | ✓ | ○ |
| SD | Joint stabilisation | ✓ | ✓ | ✓ |
| SD | Lacrimation increased | ✓ | · | ✓ |
| SD | Pre-existing disease | ✓ | · | ○ |
| SD | Rhinorrhoea | ✓ | · | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SD | Somnolence | ✓ | · | ✓ |
| SD | Upper-airway cough syndrome | ✓ | · | ✓ |
| SD | Vaginal polyp | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release