4QW-22130-54366
4 vaccinations
5 coded responses
23 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 986 / WA
- Registered
- 2021-10-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-21
Dose 1 — Pfizer-BioNTech
-
2021-04-23
Dose 2 — Pfizer-BioNTech
-
2021-10-29
Registered in v-safe
-
2021-10-29
Dose 3 — Pfizer-BioNTech
-
2021-10-29
Survey response — day 0, dose 3MedDRA: Hypoaesthesia, Immediate post-injection reaction, Swelling, Swelling face — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: Had a couple hours of mild numbness/swelling feeling in L side neck and lowrr face/jaw starting about 25 mins after vaccineMedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
-
2021-11-05
Survey response — day 7, dose 3MedDRA: Dry throat, Oropharyngeal pain, Pulmonary congestion — Feeling: FairFree text: Slightly dry sore throat. Mild congestion in lungs but improved by afternoon. Symptoms showed up overnightMedDRA releases: 2024-11 · check-in free text available
- 2021-11-12
-
2021-11-19
Survey response — day 21, dose 3MedDRA: Anxiety, Chest discomfort, Nervousness, Pre-existing disease, Ventricular extrasystoles — Feeling: FairFree text: Periodic increase in pvc's from normal, at times with faint discomfort in L chest. Some nervous feeling . Suspect is related to anxiety which I've had in past.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-26
- 2021-12-03
-
2021-12-10
Survey response — day 42, dose 3MedDRA: Abdominal pain lower, Body temperature increased, Faeces hard, Fatigue, Flatulence, Headache, Nausea, Office visit — 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 visitFree text: Intermittent low abdominal pain primarily L side, nausea at times, frequent small dry BM's & gas , mild fever (99.5F) off&on a couple days, fatigued, headache for 1/2 day, lasted about 5-6 days and just getting over it. Doc visit thought it a virus.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-10
Report sent to call center — day 42, dose 3Be 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)
-
2021-12-13
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-28
-
2022-04-11
Dose 4 — Moderna
- 2022-04-15
-
2022-04-16
Survey response — days 1–6 daily, dose 4MedDRA: Oropharyngeal pain — Feeling: FairFree text: Slight sord throat overnight - resolved todayMedDRA releases: 2024-11 · check-in free text available
- 2022-04-17
- 2022-04-18
- 2022-04-25
- 2022-05-02
- 2022-05-09
- 2022-05-18
- 2022-05-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-21 | Pfizer-BioNTech | No |
| 2 | 2021-04-23 | Pfizer-BioNTech | No |
| 3 | 2021-10-29 | Pfizer-BioNTech | No |
| 4 | 2022-04-11 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 10 — day 0, dose 3
Systemic reaction (other): Had a couple hours of mild numbness/swelling feeling in L side neck and lowrr face/jaw starting about 25 mins after vaccine
Release 10 — day 7, dose 3
Systemic reaction (other): Slightly dry sore throat. Mild congestion in lungs but improved by afternoon. Symptoms showed up overnight
Release 10 — day 21, dose 3
Symptoms: Periodic increase in pvc's from normal, at times with faint discomfort in L chest. Some nervous feeling . Suspect is related to anxiety which I've had in past.
Release 10 — day 42, dose 3
Symptoms: Intermittent low abdominal pain primarily L side, nausea at times, frequent small dry BM's & gas , mild fever (99.5F) off&on a couple days, fatigued, headache for 1/2 day, lasted about 5-6 days and just getting over it. Doc visit thought it a virus. cut off by CDC
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Slight sord throat overnight - resolved today
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 | Abdominal pain lower | · | · | ✓ |
| SD | Anxiety | · | · | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Faeces hard | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Flatulence | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Nervousness | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Ventricular extrasystoles | · | · | ✓ |
| SRO | Dry throat | · | · | ✓ |
| SRO | Hypoaesthesia | · | · | ✓ |
| SRO | Immediate post-injection reaction | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Pulmonary congestion | · | · | ✓ |
| SRO | Swelling | · | · | ✓ |
| SRO | Swelling face | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release