5C8-16481-47723
3 vaccinations
5 coded responses
34 check-ins
5 free-text entries
4 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 955 / CA
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-27
Dose 1 — Pfizer-BioNTech
-
2021-01-28
Registered in v-safe
- 2021-01-28
- 2021-01-29
-
2021-01-30
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-31
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-10
- 2021-02-17
-
2021-02-18
Dose 2 — Pfizer-BioNTech
-
2021-02-19
Survey response — days 1–6 daily, dose 2MedDRA: Fall, Mobility decreased, Pre-existing disease — Feeling: Fair · Fatigue or tiredness · Be unable to workFree text: Fell, but likely due to fragile condition with history of falls and mobility issuesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-03-04
-
2021-03-12
Survey response — day 21, dose 2MedDRA: International normalised ratio decreased, Office visit, Pre-existing disease, Rectal haemorrhage, Self-medication, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Rectal bleeding, 03/10/21 and 03/11/21. On Warfarin for Afib for years.Todays INR 1.7. Stopped NSAID on 03/11/21. Being followed by primary doctor, and local Coumadin clinic · Healthcare visit (other): Lab workMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-12
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-18
- 2021-03-27
- 2021-04-03
- 2021-05-20
-
2021-08-21
Survey response — 6 months, dose 2MedDRA: Anaemia, International normalised ratio abnormal, Pre-existing disease, Urinary incontinence — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Worsening anemia, urinary incontinence, altered INRMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-21
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-26
Dose 3 — Pfizer-BioNTechCo-administered: Flu
- 2021-09-29
-
2021-09-30
Health check-in — days 1–6 daily, dose 3Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-10-03
- 2021-10-10
- 2021-10-17
- 2021-10-24
- 2021-10-31
- 2021-11-07
- 2021-11-11
- 2021-12-27
-
2022-03-27
Survey response — 6 months, dose 3MedDRA: Condition aggravated, Hypertension, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Aortic aneurysm worsening. Treated for hypertension, but over medicated Now better. Still just OLD. No Covid, though.MedDRA releases: 2024-11 · check-in free text available
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2022-03-27
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-03-31
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2022-09-26
Survey response — 12 months, dose 3MedDRA: Dysphagia, Hospice care, Metabolic encephalopathy, Pneumonia aspiration, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Symptoms: CHF, severe dysphagia, aspiration pneumonia, metabolic encephalopathy · Healthcare visit (other): HOSPICEMedDRA releases: 2024-11 · check-in free text available
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2022-09-26
Report sent to call center — 12 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
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2022-09-27
Call successfulDoes not wish to fill out VAERS report
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2022-09-27
Call successfulDoes not wish to fill out VAERS report
-
2022-09-27
Call successfulDoes not wish to fill out VAERS report
-
2022-09-27
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-27 | Pfizer-BioNTech | |
| 2 | 2021-02-18 | Pfizer-BioNTech | |
| 3 | 2021-09-26 | Pfizer-BioNTech | Flu |
Call center
4 call center cases
4 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Fell, but likely due to fragile condition with history of falls and mobility issues
Release 5 — day 21, dose 2
Symptoms: Rectal bleeding, 03/10/21 and 03/11/21. On Warfarin for Afib for years.Todays INR 1.7. Stopped NSAID on 03/11/21. Being followed by primary doctor, and local Coumadin clinic
Healthcare visit (other): Lab work
Release 9 — 6 months, dose 2
Symptoms: Worsening anemia, urinary incontinence, altered INR
Release 11 — 6 months, dose 3
Symptoms: Aortic aneurysm worsening. Treated for hypertension, but over medicated Now better. Still just OLD. No Covid, though.
Release 12 — 12 months, dose 3
Symptoms: CHF, severe dysphagia, aspiration pneumonia, metabolic encephalopathy
Healthcare visit (other): HOSPICE
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 | Hospice care | · | · | ✓ |
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Anaemia | ✓ | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Dysphagia | · | · | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | International normalised ratio abnormal | ✓ | · | ✓ |
| SD | International normalised ratio decreased | ✓ | · | ✓ |
| SD | Metabolic encephalopathy | · | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Pneumonia aspiration | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Rectal haemorrhage | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | · | ✓ |
| SD | Urinary incontinence | ✓ | · | ✓ |
| SRO | Fall | ✓ | ✓ | ✓ |
| SRO | Mobility decreased | ○ | ✓ | ○ |
| SRO | Pre-existing disease | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release