4RA-15295-09738
2 vaccinations
4 coded responses
23 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 490 / MI
- Registered
- 2021-01-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-16
Registered in v-safe
-
2021-01-16
Dose 1 — Pfizer-BioNTech
- 2021-01-16
-
2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease, Rheumatoid arthritis — Feeling: Good · Joint painsFree text: Because of "overactive" rheumatoid, it's hard to tell if the joint pain is just RA. orMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-30
-
2021-02-13
Dose 2 — Pfizer-BioNTech
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
-
2021-05-15
Survey response — 3 months, dose 2MedDRA: Office visit, Vertigo, Vestibular disorder — 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, Emergency room or emergency department visitFree text: Symptoms: Extreme vertigo related to vestibular problems in the ears. Unknown cause, various tests & doctors. · Healthcare visit (other): In-office dr appt.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-15
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-14
Survey response — 6 months, dose 2MedDRA: Balance disorder, Ear disorder, Vertigo — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: A vestibular balance/vertigo issue due to problem in left ear canal.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-14
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-18
-
2022-02-13
Survey response — 12 months, dose 2MedDRA: Exposure to fungus, Pneumonitis, SARS-CoV-2 test negative, Sinusitis, Visual impairment — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Pneumonitis, sinusitis, vision problem, all due to airborne mold particles blown into our apartment bc of major H20 leak in our bldg. Had covid test - negative.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-13
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2022-02-15
-
2022-02-16
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Pfizer-BioNTech | |
| 2 | 2021-02-13 | Pfizer-BioNTech |
Call center
3 call center cases
3 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Because of "overactive" rheumatoid, it's hard to tell if the joint pain is just RA. or
Release 8 — 3 months, dose 2
Symptoms: Extreme vertigo related to vestibular problems in the ears. Unknown cause, various tests & doctors.
Healthcare visit (other): In-office dr appt.
Release 9 — 6 months, dose 2
Symptoms: A vestibular balance/vertigo issue due to problem in left ear canal.
Release 11 — 12 months, dose 2
Symptoms: Pneumonitis, sinusitis, vision problem, all due to airborne mold particles blown into our apartment bc of major H20 leak in our bldg. Had covid test - negative.
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Balance disorder | ✓ | · | ✓ |
| SD | Ear disorder | ✓ | · | ✓ |
| SD | Exposure to fungus | · | · | ✓ |
| SD | Pneumonitis | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Vertigo | ✓ | ✓ | ✓ |
| SD | Vestibular disorder | ✓ | ✓ | ✓ |
| SD | Visual impairment | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rheumatoid arthritis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release