55W-29775-89156
2 vaccinations
7 coded responses
12 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 850 / AZ
- Registered
- 2021-01-18
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
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2020-12-28
Dose 1 — Pfizer-BioNTech
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2021-01-18
Registered in v-safe
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2021-01-18
Dose 2 — Pfizer-BioNTech
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2021-01-18
Survey response — day 0, dose 2MedDRA: Dry mouth, Hot flush — Feeling: Good · Fatigue or tirednessFree text: Hot flashes lasting a couple minutes at a time and dry mouth.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-19
Survey response — days 1–6 daily, dose 2MedDRA: Insomnia, Muscle spasms — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessFree text: Spasms in my deltoid lasting all night. Caused insomnia.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-21
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-22
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2021-01-23
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain — Feeling: Good · Joint painsFree text: Soreness in my armpit since about 24 hour after the injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-24
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain — Feeling: Good · Site: Pain · HeadacheFree text: Pain in my armpit.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-25
Survey response — day 7, dose 2MedDRA: Axillary pain — Feeling: Good · Site: Pain · Joint painsFree text: Pain in the armpitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-01
- 2021-02-10
- 2021-02-17
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2021-07-19
Survey response — 6 months, dose 2MedDRA: Asthma, Ear infection, General physical health deterioration, Hepatic steatosis, Insulin resistant diabetes, Pre-existing disease, Sinusitis, Type 2 diabetes mellitus — 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 consultation, Outpatient clinic or urgent care clinic visitFree text: I was diagnosed about 1 month ago with diabetes type 2, insulin resistance, and a fatty liver. I have also had a really bad asthma exacerbation, sinus infection, and ear infection lasti g approximatly 2 weeks so far. My health has declinedMedDRA releases: 2024-11 · check-in free text available
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2021-07-19
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-07-26
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2022-01-18
Survey response — 12 months, dose 2MedDRA: Insulin resistant diabetes, Office visit — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: I was diagnosed with Diabetes and insulin resistance approximatly 1 to 2 months after my 2nd vaccine. · Healthcare visit (other): Specialist endocrinologistMedDRA releases: 2024-11 · check-in free text available
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2022-01-18
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-01-19
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Pfizer-BioNTech | |
| 2 | 2021-01-18 | Pfizer-BioNTech |
Call center
2 call center cases
2 successful
Free text
Release 2 — day 0, dose 2
Systemic reaction (other): Hot flashes lasting a couple minutes at a time and dry mouth.
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Spasms in my deltoid lasting all night. Caused insomnia.
Systemic reaction (other): Soreness in my armpit since about 24 hour after the injection.
Systemic reaction (other): Pain in my armpit.
Release 2 — day 7, dose 2
Systemic reaction (other): Pain in the armpit
Release 9 — 6 months, dose 2
Symptoms: I was diagnosed about 1 month ago with diabetes type 2, insulin resistance, and a fatty liver. I have also had a really bad asthma exacerbation, sinus infection, and ear infection lasti g approximatly 2 weeks so far. My health has declined
Release 10 — 12 months, dose 2
Symptoms: I was diagnosed with Diabetes and insulin resistance approximatly 1 to 2 months after my 2nd vaccine.
Healthcare visit (other): Specialist endocrinologist
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 | Asthma | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | General physical health deterioration | · | · | ✓ |
| SD | Hepatic steatosis | · | · | ✓ |
| SD | Insulin resistant diabetes | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Type 2 diabetes mellitus | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Dry mouth | ✓ | ✓ | ✓ |
| SRO | Hot flush | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release