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4VZ-21278-45060

2 vaccinations 9 coded responses 17 check-ins 9 free-text entries 1 call case
Sex
Male
Age at first dose
61-65
ZIP prefix
890 / NV
Registered
2021-09-10
Relationship
Self
Race
Asian
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-09-10
    Registered in v-safe
  2. 2021-09-10
    Dose 1 — Pfizer-BioNTech
  3. 2021-09-10
    Health check-in — day 0, dose 1
    Feeling: Fair · Site: Pain · Joint pains
    Adult check-in
  4. 2021-09-13
    Survey response — days 1–6 daily, dose 1
    MedDRA: Neck pain — Feeling: Fair · Site: Itching · Muscle or body aches
    Free text: Neck PAin
    MedDRA releases: 2024-11 · check-in free text available
  5. 2021-09-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Facial pain, Neck pain — Feeling: Fair
    Free text: Back of neck pain & pain left side of my face
    MedDRA releases: 2024-11 · check-in free text available
  6. 2021-09-15
    Survey response — days 1–6 daily, dose 1
    MedDRA: Abdominal pain upper — Feeling: Fair
    Free text: When I woke up I feel pain in my right side stomach
    MedDRA releases: 2024-11 · check-in free text available
  7. 2021-09-16
    Survey response — days 1–6 daily, dose 1
    MedDRA: Insomnia — Feeling: Fair
    Free text: Loosing sleep, our air conditioner broke down almost a month now, Fidelity National Insurance is taking their to pick it, it is too hot here in (b)(6)
    MedDRA releases: 2024-11 · check-in free text available
  8. 2021-09-17
    Survey response — day 7, dose 1
    MedDRA: Cataract, Pre-existing disease — Feeling: Fair
    Free text: Noticed My left eye cataract get more advance
    MedDRA releases: 2024-11 · check-in free text available
  9. 2021-09-26
    Health check-in — day 14, dose 1
    Feeling: Fair
    Adult check-in
  10. 2021-10-03
    Health check-in — day 21, dose 1
    Feeling: Fair
    Adult check-in
  11. 2021-10-08
    Health check-in — day 28, dose 1
    Feeling: Fair
    Adult check-in
  12. 2021-10-11
    Dose 2 — Pfizer-BioNTech
  13. 2021-10-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · None
    Adult check-in
  14. 2021-10-16
    Survey response — days 1–6 daily, dose 2
    MedDRA: Rash — Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection site
    Free text: Rashes on both elbows
    MedDRA releases: 2024-11 · check-in free text available
  15. 2021-10-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: Rash — Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection site
    Free text: Rashes on both elbows
    MedDRA releases: 2024-11 · check-in free text available
  16. 2021-10-18
    Survey response — day 7, dose 2
    MedDRA: Rash — Feeling: Fair · Rash, not including the immediate area around the injection site
    Free text: Rashes on arms & elbows
    MedDRA releases: 2024-11 · check-in free text available
  17. 2021-10-27
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  18. 2021-11-03
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  19. 2021-11-11
    Survey response — day 28, dose 2
    MedDRA: Chest pain, Gastrooesophageal reflux disease, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Went to Urgent Care Clinic for chest pain, got X-ray, EKG, & blood test for stomach virus. Result: severe acid reflux.
    MedDRA releases: 2024-11 · check-in free text available
  20. 2021-11-11
    Report sent to call center — day 28, dose 2
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  21. 2021-11-16
  22. 2021-11-17
  23. 2021-11-22
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-09-10Pfizer-BioNTech No
22021-10-11Pfizer-BioNTech No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 1

2021-09-13

Systemic reaction (other): Neck PAin

2021-09-14

Systemic reaction (other): Back of neck pain & pain left side of my face

2021-09-15

Systemic reaction (other): When I woke up I feel pain in my right side stomach

2021-09-16

Systemic reaction (other): Loosing sleep, our air conditioner broke down almost a month now, Fidelity National Insurance is taking their to pick it, it is too hot here in (b)(6)
redacted (b)(6)

Release 9 — day 7, dose 1

2021-09-17

Systemic reaction (other): Noticed My left eye cataract get more advance

Release 10 — days 1–6 daily, dose 2

2021-10-16

Systemic reaction (other): Rashes on both elbows

2021-10-17

Systemic reaction (other): Rashes on both elbows

Release 10 — day 7, dose 2

2021-10-18

Systemic reaction (other): Rashes on arms & elbows

Release 10 — day 28, dose 2

2021-11-11

Symptoms: Went to Urgent Care Clinic for chest pain, got X-ray, EKG, & blood test for stomach virus. Result: severe acid reflux.

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

FieldPreferred term2021-092023-042024-11
SDChest pain · · ✓
SDGastrooesophageal reflux disease · · ✓
SDOffice visit · · ✓
SROAbdominal pain upper · · ✓
SROCataract · · ✓
SROFacial pain · · ✓
SROInsomnia · · ✓
SRONeck pain · · ✓
SROPre-existing disease · · ✓
SRORash · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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