4UJ-22019-09901
5 vaccinations
5 coded responses
40 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 274 / NC
- Registered
- 2021-10-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-12
Dose 1 — Pfizer-BioNTech
-
2021-04-02
Dose 2 — Pfizer-BioNTech
-
2021-10-22
Dose 3 — Pfizer-BioNTech
-
2021-10-23
Registered in v-safe
-
2021-10-23
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-24
- 2021-10-25
-
2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: Atrial fibrillation, Office visit, Pericarditis — Feeling: Fair · Fatigue or tirednessFree text: 6 hr AFIB episode. This happened days 4,5 and 7 after the 2nd shot. Cardiologist said vaccine caused inflammation around my heart. She said her the 3rd shot. Extra AFIB episodes are less risky to me than COVID per cardiologist.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-11-05
- 2021-11-13
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2022-01-21
- 2022-04-22
-
2022-06-08
Dose 4 — Pfizer-BioNTech
-
2022-06-08
Survey response — day 0, dose 4MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2022-06-09
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-06-10
-
2022-06-11
Survey response — days 1–6 daily, dose 4MedDRA: Atrial fibrillation, Vaccine positive rechallenge — Feeling: GoodFree text: Minor AFIB episode yesterday after my last check in. It may or may not be related to the vaccine but I have experienced AFIB episodes with the last two shots. This one was very minor and could have been fun another issue.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-12
- 2022-06-13
- 2022-06-14
- 2022-06-15
- 2022-06-22
- 2022-06-29
- 2022-07-06
- 2022-07-13
- 2022-07-20
- 2022-09-07
-
2022-09-13
Dose 5 — Pfizer-BioNTech
- 2022-09-16
- 2022-09-17
- 2022-09-18
-
2022-09-19
Survey response — days 1–6 daily, dose 5MedDRA: Adverse reaction — Feeling: Good · Headache, Fatigue or tirednessFree text: I actually had these symptoms after my check in yesterday.MedDRA releases: 2024-11 · check-in free text available
- 2022-09-20
- 2022-09-27
-
2022-10-05
Survey response — day 21, dose 5MedDRA: Dermatitis contact, Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Contact dermatitis that caused a rash. I don't know what I touched or how I got it but it's probably not related to the vaccine.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-05
Report sent to call center — day 21, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-10-06
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-12
- 2022-10-18
- 2022-10-25
- 2022-12-13
- 2023-03-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Pfizer-BioNTech | No |
| 2 | 2021-04-02 | Pfizer-BioNTech | No |
| 3 | 2021-10-22 | Pfizer-BioNTech | No |
| 4 | 2022-06-08 | Pfizer-BioNTech | No |
| 5 | 2022-09-13 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): 6 hr AFIB episode. This happened days 4,5 and 7 after the 2nd shot. Cardiologist said vaccine caused inflammation around my heart. She said her the 3rd shot. Extra AFIB episodes are less risky to me than COVID per cardiologist.
Release 11 — day 0, dose 4
Systemic reaction (other): No
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Minor AFIB episode yesterday after my last check in. It may or may not be related to the vaccine but I have experienced AFIB episodes with the last two shots. This one was very minor and could have been fun another issue.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): I actually had these symptoms after my check in yesterday.
Release 12 — day 21, dose 5
Symptoms: Contact dermatitis that caused a rash. I don't know what I touched or how I got it but it's probably not related to the vaccine.
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 | Dermatitis contact | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Atrial fibrillation | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Office visit | · | · | ✓ |
| SRO | Pericarditis | · | · | ✓ |
| SRO | Vaccine positive rechallenge | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release