4JP-21953-19425
5 vaccinations
9 coded responses
45 check-ins
8 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 750 / TX
- Registered
- 2021-03-13
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-06
Dose 1 — Pfizer-BioNTech
-
2021-03-13
Registered in v-safe
- 2021-03-13
- 2021-03-20
-
2021-03-27
Dose 2 — Pfizer-BioNTech
- 2021-03-27
- 2021-03-28
-
2021-03-29
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Muscle or body aches, Fatigue or tirednessFree text: Take into consideration I have MS.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-30
Survey response — days 1–6 daily, dose 2MedDRA: Pre-existing disease — Feeling: Good · Fatigue or tirednessFree text: Consider I do have MS.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-31
- 2021-04-02
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-04-24
- 2021-05-01
- 2021-05-08
- 2021-06-27
-
2021-08-18
Dose 3 — Pfizer-BioNTech
-
2021-09-25
Survey response — 6 months, dose 2MedDRA: Breast cancer, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Diagnosed with breast cancer on August 9th. I believe due to Ocrevus infusion I was taking for Multiple Sclerosis. · Healthcare visit (other): One on one with breast surgeon.MedDRA releases: 2024-11 · check-in free text available
-
2021-09-25
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-30
-
2021-09-30
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-10-02
Survey response — day 42, dose 3MedDRA: Breast cancer — Feeling: GoodFree text: Diagnosed with Breast Cancer.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-17
Survey response — 3 months, dose 3MedDRA: Breast cancer, Breast conserving surgery, Breast operation — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Had Breast Cancer Surgery: · Healthcare visit (other): Too many to type, had lumpectomy to remove mass.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-17
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-18
-
2022-02-16
Survey response — 6 months, dose 3MedDRA: Breast cancer — Feeling: GoodFree text: Breast CancerMedDRA releases: 2024-11 · check-in free text available
-
2022-05-12
Dose 4 — Pfizer-BioNTech
-
2022-05-14
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Itching · Muscle or body aches, DiarrheaAdult check-in
-
2022-05-15
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Itching · Muscle or body achesAdult check-in
- 2022-05-16
- 2022-05-17
- 2022-05-18
- 2022-05-19
- 2022-05-26
- 2022-06-02
- 2022-06-09
- 2022-06-16
- 2022-06-23
- 2022-08-11
-
2022-11-15
Dose 5 — Pfizer-BioNTechCo-administered: Flu
-
2022-11-16
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-11-16
Survey response — 6 months, dose 4MedDRA: Pain in extremity — Feeling: FairFree text: Just received the new PFIZER COVID BIVAL (12Y UP)EUA shot yesterday. Thus far just experiencing soreness in my arm.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-18
- 2022-11-19
-
2022-11-20
Survey response — days 1–6 daily, dose 5MedDRA: Multiple sclerosis, Rheumatoid arthritis — Feeling: Good · Muscle or body achesFree text: I have MS and RAMedDRA releases: 2024-11 · check-in free text available
- 2022-11-21
- 2022-11-22
- 2022-11-29
- 2022-12-06
- 2022-12-13
- 2022-12-20
- 2022-12-27
- 2023-02-14
-
2023-05-17
Survey response — 6 months, dose 5MedDRA: No adverse event — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-06 | Pfizer-BioNTech | |
| 2 | 2021-03-27 | Pfizer-BioNTech | |
| 3 | 2021-08-18 | Pfizer-BioNTech | No |
| 4 | 2022-05-12 | Pfizer-BioNTech | No |
| 5 | 2022-11-15 | Pfizer-BioNTech | Flu |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Take into consideration I have MS.
Systemic reaction (other): Consider I do have MS.
Release 9 — 6 months, dose 2
Symptoms: Diagnosed with breast cancer on August 9th. I believe due to Ocrevus infusion I was taking for Multiple Sclerosis.
Healthcare visit (other): One on one with breast surgeon.
Release 9 — day 42, dose 3
Symptoms: Diagnosed with Breast Cancer.
Release 10 — 3 months, dose 3
Symptoms: Had Breast Cancer Surgery:
Healthcare visit (other): Too many to type, had lumpectomy to remove mass.
Release 11 — 6 months, dose 3
Symptoms: Breast Cancer
Release 12 — 6 months, dose 4
Symptoms: Just received the new PFIZER COVID BIVAL (12Y UP)EUA shot yesterday. Thus far just experiencing soreness in my arm.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): I have MS and RA
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 | Breast conserving surgery | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Breast cancer | · | · | ✓ |
| SD | Breast operation | · | · | ✓ |
| SD | No adverse event | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Multiple sclerosis | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rheumatoid arthritis | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release