4RV-67541-04868
4 vaccinations
10 coded responses
49 check-ins
10 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 144 / NY
- Registered
- 2021-02-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Dose 1 — Pfizer-BioNTech
-
2021-02-06
Registered in v-safe
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
-
2021-02-24
Dose 2 — Pfizer-BioNTech
-
2021-02-24
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: Good · Site: PainFree text: It has been only 3 hours since inoculation, so no sumptoms yet.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-02-28
-
2021-03-01
Survey response — days 1–6 daily, dose 2MedDRA: Arthritis, Pre-existing disease — Feeling: Good · Joint painsFree text: Have arthritis in left knee where I am experiencing some pain. Had no discomfort in the 6 months prior to receiving the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
- 2021-03-03
-
2021-03-10
Survey response — day 14, dose 2MedDRA: Arthralgia, Mobility decreased, Pre-existing disease — Feeling: GoodFree text: Knee with arthritis is still very sore and mobility is limited but does not keep me from routine chores.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-17
- 2021-03-24
-
2021-03-31
Survey response — day 35, dose 2MedDRA: Eye infection, Specialist consultation — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Eye infection · Healthcare visit (other): OpthamologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-31
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-07
-
2021-05-26
Survey response — 3 months, dose 2MedDRA: Vertigo — Feeling: FairFree text: VertigoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-25
-
2021-10-02
Dose 3 — Pfizer-BioNTech
-
2021-10-02
Survey response — day 0, dose 3MedDRA: Pre-existing disease — Feeling: Good · Site: PainFree text: Vaccination was only 5 hours ago. Also, at end of August I. Was diagnosed with blood clots in my left leg.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-03
-
2021-10-04
Survey response — days 1–6 daily, dose 3MedDRA: Thrombosis — Feeling: Good · DiarrheaFree text: Recently diagnosed with blood clots. On blood thinner medication.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-05
- 2021-10-06
- 2021-10-07
- 2021-10-08
- 2021-10-09
- 2021-10-16
- 2021-10-23
- 2021-10-30
- 2021-11-06
-
2021-11-13
Survey response — day 42, dose 3MedDRA: Office visit, Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Urinary track infection. · Healthcare visit (other): Office visit, primary care doctorMedDRA releases: 2024-11 · check-in free text available
-
2021-11-13
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-15
-
2021-11-15
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-01
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2022-04-02
Survey response — 6 months, dose 3MedDRA: Diplopia, Office visit, VIth nerve disorder — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Double vision on left side. 6th nerve is weak. May resolve itself in 6 to 8 weeks. · Healthcare visit (other): Ophthalmology appointment with referral to neuro ophthalmologistMedDRA releases: 2024-11 · check-in free text available
-
2022-04-02
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-04-05
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-09-29
Dose 4 — Pfizer-BioNTech
- 2022-09-29
- 2022-09-30
- 2022-10-01
- 2022-10-02
-
2022-10-03
Survey response — days 1–6 daily, dose 4MedDRA: Blood glucose increased — Feeling: GoodFree text: Blood sugars have been slightly higher since vaccination but don't know if they are related.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-04
- 2022-10-05
- 2022-10-06
- 2022-10-13
- 2022-10-20
- 2022-10-27
- 2022-11-03
- 2022-11-10
- 2022-12-29
- 2023-03-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Pfizer-BioNTech | |
| 2 | 2021-02-24 | Pfizer-BioNTech | |
| 3 | 2021-10-02 | Pfizer-BioNTech | No |
| 4 | 2022-09-29 | Pfizer-BioNTech | No |
Call center
3 call center cases
3 successful
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): It has been only 3 hours since inoculation, so no sumptoms yet.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Have arthritis in left knee where I am experiencing some pain. Had no discomfort in the 6 months prior to receiving the vaccine.
Release 5 — day 14, dose 2
Symptoms: Knee with arthritis is still very sore and mobility is limited but does not keep me from routine chores.
Release 6 — day 35, dose 2
Release 8 — 3 months, dose 2
Symptoms: Vertigo
Release 9 — day 0, dose 3
Systemic reaction (other): Vaccination was only 5 hours ago. Also, at end of August I. Was diagnosed with blood clots in my left leg.
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Recently diagnosed with blood clots. On blood thinner medication.
Release 10 — day 42, dose 3
Symptoms: Urinary track infection.
Healthcare visit (other): Office visit, primary care doctor
Release 11 — 6 months, dose 3
Symptoms: Double vision on left side. 6th nerve is weak. May resolve itself in 6 to 8 weeks.
Healthcare visit (other): Ophthalmology appointment with referral to neuro ophthalmologist
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Blood sugars have been slightly higher since vaccination but don't know if they are related.
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 | · | · | ✓ |
| HCVO | Specialist consultation | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Diplopia | · | · | ✓ |
| SD | Eye infection | ✓ | ✓ | ✓ |
| SD | Mobility decreased | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SD | Vertigo | ✓ | ✓ | ✓ |
| SD | VIth nerve disorder | · | · | ✓ |
| SRO | Arthritis | ✓ | ✓ | ✓ |
| SRO | Blood glucose increased | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Thrombosis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release