556-27788-03059
2 vaccinations
6 coded responses
17 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 088 / NJ
- Registered
- 2021-03-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-15
Registered in v-safe
-
2021-03-15
Dose 1 — Pfizer-BioNTech
- 2021-03-15
- 2021-03-16
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2021-03-17
Survey response — days 1–6 daily, dose 1MedDRA: Vitreous floaters — Feeling: Fair · Headache, Fatigue or tirednessFree text: Last night at dinner time I developed a floating spot on my right eye which is still here today. Not sure it is related but this never happened to me before.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Survey response — days 1–6 daily, dose 1MedDRA: Visual impairment — Feeling: GoodFree text: The spot floating in my right eye is still present. Again this is new to me but not sure it is related to the shot. I will see a doctor if it does not clear by the weekend.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Survey response — days 1–6 daily, dose 1MedDRA: Eye disorder — Feeling: GoodFree text: Eye still a problem. Will see an eye doctor next week to check it out. Again it happened about 24 hours after 1st shot. But not sure it would be a related event.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-20
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: Eye still the same.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
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2021-03-29
Survey response — day 14, dose 1MedDRA: Office visit, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: As previously noted I developed a spot on my eye. Since last update I developed a 2nd spot. Not sure it is related to the shot but I never had this before the vaccine & it happen about 26 hours after the shot. · Healthcare visit (other): Eye doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-29
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-07
Dose 2 — Pfizer-BioNTech
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2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Headache, Pain in extremity, Pruritus — Feeling: GoodFree text: I had the shot a week ago. I had sore arm fatigue headache and itching on the 3rd day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-13
- 2021-04-23
- 2021-04-28
- 2021-05-05
- 2021-05-13
- 2021-05-21
- 2021-10-07
- 2022-01-20
- 2022-04-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-15 | Pfizer-BioNTech | |
| 2 | 2021-04-07 | Pfizer-BioNTech |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Last night at dinner time I developed a floating spot on my right eye which is still here today. Not sure it is related but this never happened to me before.
Systemic reaction (other): The spot floating in my right eye is still present. Again this is new to me but not sure it is related to the shot. I will see a doctor if it does not clear by the weekend.
Systemic reaction (other): Eye still a problem. Will see an eye doctor next week to check it out. Again it happened about 24 hours after 1st shot. But not sure it would be a related event.
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Eye still the same.
Release 6 — day 14, dose 1
Symptoms: As previously noted I developed a spot on my eye. Since last update I developed a 2nd spot. Not sure it is related to the shot but I never had this before the vaccine & it happen about 26 hours after the shot.
Healthcare visit (other): Eye doctor
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I had the shot a week ago. I had sore arm fatigue headache and itching on the 3rd day.
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 | ✓ | ✓ | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Eye disorder | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Visual impairment | ✓ | ✓ | ✓ |
| SRO | Vitreous floaters | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release