55M-12457-34690
3 vaccinations
6 coded responses
25 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 300 / GA
- Registered
- 2021-02-06
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-06
Registered in v-safe
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2021-02-06
Dose 1 — Pfizer-BioNTech
- 2021-02-06
-
2021-02-08
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Poor · Site: Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-09
Survey response — days 1–6 daily, dose 1MedDRA: Diarrhoea — Feeling: Good · Site: Pain · Joint pains · Be unable to do your normal daily activitiesFree text: I had a little diarrhea last evening that I forgot to report. It has sense cleared up.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-10
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-11
-
2021-02-12
Survey response — days 1–6 daily, dose 1MedDRA: Cardiac flutter — Feeling: Good · Site: Pain · Joint pains, Muscle or body achesFree text: Some unexplained flutterings in my chest area that started yesterday, but has not occurred again in the last six hours.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
-
2021-02-20
Dose 2 — Pfizer-BioNTech
- 2021-02-20
-
2021-03-13
Survey response — day 21, dose 2MedDRA: Breast pain, Chest pain, Headache, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I experienced an excruciating headache that didnt last long, pains shooting through my breast, some disturbances in my chest around my heart area. · Healthcare visit (other): I had to physically go into my doctors office for an examination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-13
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-20
Survey response — day 28, dose 2MedDRA: Mobility decreased, Nasal congestion, Neck pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Stuff, painful neck that prevents me from turning it to the left a complete 90 degrees.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-28
- 2021-04-03
- 2021-05-23
- 2021-08-21
-
2021-09-27
Dose 3 — Pfizer-BioNTech
- 2021-10-01
- 2021-10-03
- 2021-10-04
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2021-10-11
Survey response — day 14, dose 3MedDRA: Dyspnoea, Sleep disorder — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I have had trouble breathing, and it catching my breath, especially at night. Three nights in a row I had to get up out of bed because I couldn't breath.MedDRA releases: 2024-11 · check-in free text available
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2021-10-11
Report sent to call center — day 14, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
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2021-10-12
Call successfulDoes not wish to fill out VAERS report
- 2021-10-18
- 2021-10-25
- 2021-11-01
- 2021-11-08
- 2021-12-27
- 2022-03-28
- 2022-09-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-06 | Pfizer-BioNTech | |
| 2 | 2021-02-20 | Pfizer-BioNTech | |
| 3 | 2021-09-27 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): No
Systemic reaction (other): I had a little diarrhea last evening that I forgot to report. It has sense cleared up.
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Some unexplained flutterings in my chest area that started yesterday, but has not occurred again in the last six hours.
Release 5 — day 21, dose 2
Symptoms: I experienced an excruciating headache that didnt last long, pains shooting through my breast, some disturbances in my chest around my heart area.
Healthcare visit (other): I had to physically go into my doctors office for an examination.
Release 6 — day 28, dose 2
Symptoms: Stuff, painful neck that prevents me from turning it to the left a complete 90 degrees.
Release 10 — day 14, dose 3
Symptoms: I have had trouble breathing, and it catching my breath, especially at night. Three nights in a row I had to get up out of bed because I couldn't breath.
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 | Breast pain | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Mobility decreased | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Sleep disorder | · | · | ✓ |
| SRO | Cardiac flutter | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release