4Z2-99467-81227
4 vaccinations
11 coded responses
37 check-ins
11 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 076 / NJ
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-11
Registered in v-safe
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2021-03-11
Dose 1 — Pfizer-BioNTech
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2021-03-11
Survey response — day 0, dose 1MedDRA: Dyspnoea — Feeling: Fair · Fatigue or tirednessFree text: Shortness of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Survey response — days 1–6 daily, dose 1MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessFree text: Brain fog increasedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-13
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-14
Survey response — days 1–6 daily, dose 1MedDRA: Feeling abnormal — Feeling: Fair · Muscle or body aches, Fatigue or tirednessFree text: Brain fogMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-16
Survey response — days 1–6 daily, dose 1MedDRA: Ear discomfort, Ear haemorrhage, Eustachian tube disorder — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessFree text: The morning after i got a really odd left ear bleed that wouldn't stop so i plugged it with kleenex until it coagulated. Everything seemed ok until this morning when I noticed that I could feel the inner ear & eustacian tube discomfort beginning. Using hot water & q-tips i gently tried to clean away what felt like a plug. I went through about 20 2x-ends of hot watered swabbing removing dried bloody bits but never was able to clear the plug. So it feels less wonky but not the usual/normal either I consider it coincidental as it makes no sense for the vaccine#1 shot to cause an earbleed. It doesn't feel like I blew out the eardrum that would be major noticeable.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Survey response — days 1–6 daily, dose 1MedDRA: Ear haemorrhage — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessFree text: Ear bleed stopped, interfered with gabapentinMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Survey response — day 7, dose 1MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessFree text: The first 48hrs interfered with my gabapentin that i take for permantly damaged bracial plexus from an accidentMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-28
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2021-04-01
Dose 2 — Pfizer-BioNTech
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2021-04-08
Survey response — day 7, dose 2MedDRA: Dyspnoea, Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: brain fog, and shortness of breathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-07-01
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2021-09-30
Dose 3 — Pfizer-BioNTechCo-administered: Flu
- 2021-09-30
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2021-10-03
Survey response — days 1–6 daily, dose 3MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: cotton breathingMedDRA releases: 2024-11 · check-in free text available
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2021-10-04
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
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2021-10-05
Survey response — days 1–6 daily, dose 3MedDRA: Dyspnoea, Respiration abnormal — Feeling: Good · Headache, Muscle or body aches, Fatigue or tirednessFree text: breathing is a bit cottony a little short of breathMedDRA releases: 2024-11 · check-in free text available
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2021-10-06
Health check-in — days 1–6 daily, dose 3Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-10-12
- 2021-10-14
- 2021-10-21
- 2021-10-28
- 2021-11-04
- 2021-11-12
- 2021-12-30
- 2022-03-31
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2022-04-01
Dose 4 — Pfizer-BioNTech
- 2022-04-15
- 2022-04-22
- 2022-05-02
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2022-05-06
Survey response — day 35, dose 4MedDRA: Unevaluable event — Feeling: FairFree text: Breathing vapors of paradichlorobenzene that settled like a fog in our bedroom overnight from trying to kill clothes moths.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-13
- 2022-07-04
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2022-09-30
Survey response — 6 months, dose 4MedDRA: Arthropathy — Feeling: GoodFree text: Blew out right hip, replacement scheduled for end of October '22MedDRA releases: 2024-11 · check-in free text available
- 2023-04-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Pfizer-BioNTech | |
| 2 | 2021-04-01 | Pfizer-BioNTech | |
| 3 | 2021-09-30 | Pfizer-BioNTech | Flu |
| 4 | 2022-04-01 | Pfizer-BioNTech | No |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Shortness of breath
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Brain fog increased
Systemic reaction (other): Brain fog
Systemic reaction (other): The morning after i got a really odd left ear bleed that wouldn't stop so i plugged it with kleenex until it coagulated. Everything seemed ok until this morning when I noticed that I could feel the inner ear & eustacian tube discomfort beginning. Using hot water & q-tips i gently tried to clean away what felt like a plug. I went through about 20 2x-ends of hot watered swabbing removing dried bloody bits but never was able to clear the plug. So it feels less wonky but not the usual/normal either I consider it coincidental as it makes no sense for the vaccine#1 shot to cause an earbleed. It doesn't feel like I blew out the eardrum that would be major noticeable.
Systemic reaction (other): Ear bleed stopped, interfered with gabapentin
Release 5 — day 7, dose 1
Systemic reaction (other): The first 48hrs interfered with my gabapentin that i take for permantly damaged bracial plexus from an accident
Release 7 — day 7, dose 2
Systemic reaction (other): brain fog, and shortness of breath
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): cotton breathing
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): breathing is a bit cottony a little short of breath
Release 11 — day 35, dose 4
Symptoms: Breathing vapors of paradichlorobenzene that settled like a fog in our bedroom overnight from trying to kill clothes moths.
Release 12 — 6 months, dose 4
Symptoms: Blew out right hip, replacement scheduled for end of October '22
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 | Arthropathy | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Ear discomfort | ✓ | ✓ | ✓ |
| SRO | Ear haemorrhage | ✓ | ✓ | ✓ |
| SRO | Eustachian tube disorder | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Respiration abnormal | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release