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4MR-23336-00234

4 vaccinations 4 coded responses 16 check-ins 4 free-text entries 2 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
662 / KS
Registered
2021-02-19
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-28
    Dose 1 — Pfizer-BioNTech
  2. 2021-02-19
    Registered in v-safe
  3. 2021-02-19
    Dose 2 — Pfizer-BioNTech
  4. 2021-02-19
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  5. 2021-02-20
    Survey response — days 1–6 daily, dose 2
    MedDRA: Clumsiness, Dizziness — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness
    Free text: Light headed a bit, clumsy
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-21
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: I have vestibular balance issues as a precondition. Due to a tumor in cochlea many years ago. My balance seems notably worse since the second shot. Should I be concerned or will this pass in few days? My balance is always made worse by stress and fatigue. If Im feeling either or both as a result of the vaccine that could explain the increase in dizziness over the past 48 hours since the shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Diarrhea, Abdominal pain
    Adult check-in
  8. 2021-02-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  9. 2021-02-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-02-26
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-03-06
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-03-16
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  13. 2021-08-22
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-09-10
    Dose 3 — Pfizer-BioNTech
  15. 2021-09-30
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  16. 2021-10-01
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  17. 2021-10-12
    Survey response — day 28, dose 3
    MedDRA: Office visit, Pulse abnormal — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Feeling pulsing movements in abdomen. · Healthcare visit (other): Dr office visit
    MedDRA releases: 2024-11 · check-in free text available
  18. 2021-10-12
    Report sent to call center — day 28, dose 3
    Get care from a doctor or other healthcare professional
    1 call case(s)
  19. 2021-10-22
    Health check-in — day 42, dose 3
    Feeling: Fair
    Adult check-in
  20. 2021-11-12
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  21. 2021-12-10
    Survey response — 3 months, dose 3
    MedDRA: Influenza, Influenza A virus test positive, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    Free text: I was confined via positive test Influenza A. A Covid test yielded negative results. Treated for flu A. Much better now. Did have flu shot October 7, 2021. Was over flu in 7-10 days.
    MedDRA releases: 2024-11 · check-in free text available
  22. 2021-12-10
    Report sent to call center — 3 months, dose 3
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  23. 2021-12-13
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  24. 2022-04-06
    Dose 4 — Pfizer-BioNTech
  25. 2022-04-15
    Health check-in — day 7, dose 4
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-28Pfizer-BioNTech
22021-02-19Pfizer-BioNTech
32021-09-10Pfizer-BioNTech No
42022-04-06Pfizer-BioNTech No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): Light headed a bit, clumsy

2021-02-21

Systemic reaction (other): I have vestibular balance issues as a precondition. Due to a tumor in cochlea many years ago. My balance seems notably worse since the second shot. Should I be concerned or will this pass in few days? My balance is always made worse by stress and fatigue. If Im feeling either or both as a result of the vaccine that could explain the increase in dizziness over the past 48 hours since the shot.

Release 10 — day 28, dose 3

2021-10-12

Symptoms: Feeling pulsing movements in abdomen.
Healthcare visit (other): Dr office visit

Release 10 — 3 months, dose 3

2021-12-10

Symptoms: I was confined via positive test Influenza A. A Covid test yielded negative results. Treated for flu A. Much better now. Did have flu shot October 7, 2021. Was over flu in 7-10 days.

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
HCVOOffice visit · · ✓
SDInfluenza · · ✓
SDInfluenza A virus test positive · · ✓
SDPulse abnormal · · ✓
SDSARS-CoV-2 test negative · · ✓
SROClumsiness ✓ ✓ ✓
SRODizziness ✓ ✓ ✓

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