4NM-19879-07405
4 vaccinations
4 coded responses
23 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 126 / NY
- Registered
- 2021-12-14
- Relationship
- Adult relative or friend
- Guardian
- 6BF-14181-17059
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-05-04
Dose 1 — Pfizer-BioNTech
-
2021-05-25
Dose 2 — Pfizer-BioNTech
-
2021-12-10
Dose 3 — Pfizer-BioNTech
-
2021-12-14
Registered in v-safe
-
2021-12-14
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Injection site pain, Pruritus, Urticaria — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: This rash is actually hives that are on the back & side of body. This is the third day experiencing this symptom. Itching is getting better, however. Also there was some soreness at the injection sight on the first day only.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-15
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Pruritus, Rash macular, Urticaria — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Still have hives but they no longer itch (just blotchy & raised).MedDRA releases: 2024-11 · check-in free text available
-
2021-12-16
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Injection site bruising — Feeling: Good · Site: RednessFree text: There is a bruise at the injection sight that has yet to go away (6 days in).MedDRA releases: 2024-11 · check-in free text available
-
2021-12-17
Survey response — day 7, dose 3, dependentMedDRA: Injection site bruising, Urticaria — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteFree text: The hives are continuing to lessen. The injection sight bruise remains the same.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-24
- 2021-12-31
- 2022-01-07
- 2022-01-14
- 2022-01-21
- 2022-03-11
-
2022-05-06
Dose 4 — Pfizer-BioNTech
-
2022-05-07
Health check-in — days 1–6 daily, dose 4, dependentFeeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessAdult check-in
-
2022-05-09
Health check-in — days 1–6 daily, dose 4, dependentFeeling: Good · Site: Itching · NoneAdult check-in
- 2022-05-11
- 2022-05-12
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-08-05
- 2022-11-04
- 2023-05-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-04 | Pfizer-BioNTech | No |
| 2 | 2021-05-25 | Pfizer-BioNTech | No |
| 3 | 2021-12-10 | Pfizer-BioNTech | No |
| 4 | 2022-05-06 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 3, dependent
Systemic reaction (other): This rash is actually hives that are on the back & side of body. This is the third day experiencing this symptom. Itching is getting better, however. Also there was some soreness at the injection sight on the first day only.
Systemic reaction (other): Still have hives but they no longer itch (just blotchy & raised).
Systemic reaction (other): There is a bruise at the injection sight that has yet to go away (6 days in).
Release 10 — day 7, dose 3, dependent
Systemic reaction (other): The hives are continuing to lessen. The injection sight bruise remains the same.
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 |
|---|---|---|---|---|
| SRO | Injection site bruising | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Pruritus | · | · | ✓ |
| SRO | Rash macular | · | · | ✓ |
| SRO | Urticaria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release