4XR-26303-05477
2 vaccinations
5 coded responses
19 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 481 / MI
- Registered
- 2020-12-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-22
Registered in v-safe
-
2020-12-22
Dose 1 — Pfizer-BioNTech
- 2020-12-22
- 2020-12-27
- 2020-12-28
- 2020-12-29
- 2021-01-05
-
2021-01-12
Dose 2 — Pfizer-BioNTech
- 2021-01-12
-
2021-01-13
Survey response — days 1–6 daily, dose 2MedDRA: Asthenia — Feeling: Good · HeadacheFree text: Can tell I'm off a little with energyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-14
-
2021-01-17
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain — Feeling: Good · Fatigue or tirednessFree text: Soreness in armpit of injection armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-18
- 2021-01-19
- 2021-01-26
- 2021-02-02
- 2021-02-09
- 2021-02-16
-
2021-02-23
Survey response — day 42, dose 2MedDRA: Hydronephrosis, Office visit, Otitis media — Feeling: GoodFree text: Hydronephrosis of both kidneys. Not sure whats going on but my doctor is trying to figure that out.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-13
-
2021-07-13
Survey response — 6 months, dose 2MedDRA: Hydronephrosis — Feeling: GoodFree text: Severe hydronephrosis of both kidneys.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2022-01-12
Survey response — 12 months, dose 2MedDRA: COVID-19, Headache, Hydronephrosis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Minor headaches a couple times a week. Never got headaches before. Severe hydronephrosis of both kidneys, not sure what caused this. Contracted Covid twice since being vaccinated but all the health issues were before I had Covid.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-12
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-22 | Pfizer-BioNTech | |
| 2 | 2021-01-12 | Pfizer-BioNTech |
Call center
1 call center case
1 unsuccessful
Free text
Release 1 — days 1–6 daily, dose 2
Systemic reaction (other): Can tell I'm off a little with energy
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Soreness in armpit of injection arm
Release 4 — day 42, dose 2
Symptoms: Hydronephrosis of both kidneys. Not sure whats going on but my doctor is trying to figure that out.
Release 9 — 6 months, dose 2
Symptoms: Severe hydronephrosis of both kidneys.
Release 10 — 12 months, dose 2
Symptoms: Minor headaches a couple times a week. Never got headaches before. Severe hydronephrosis of both kidneys, not sure what caused this. Contracted Covid twice since being vaccinated but all the health issues were before I had Covid.
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 | COVID-19 | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hydronephrosis | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Otitis media | ○ | ✓ | ○ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release