5J4-85658-73197
4 vaccinations
5 coded responses
52 check-ins
5 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 980 / WA
- Registered
- 2021-04-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-13
Registered in v-safe
-
2021-04-13
Dose 1 — Pfizer-BioNTech
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-17
- 2021-04-19
- 2021-04-20
- 2021-04-27
-
2021-05-04
Dose 2 — Pfizer-BioNTech
-
2021-05-04
Survey response — day 0, dose 2MedDRA: Aura, Medical counselling — Feeling: Good · Site: Pain · Headache · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Systemic reaction (other): Visual aura in one eye (started 3 hours after shot, lasted ~30 minutes) · Healthcare visit (other): Called re: visual auraMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-04
Report sent to call center — day 0, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-05-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, HeadacheAdult check-in
- 2021-05-06
- 2021-05-07
- 2021-05-08
- 2021-05-09
- 2021-05-10
- 2021-05-11
-
2021-05-18
Survey response — day 14, dose 2MedDRA: Aura — Feeling: GoodFree text: Brief recurrence of eye aura in right eye. Similar to day of 2nd shot (reported via this website/ app). Lasted 5-10 minutes.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-25
- 2021-06-01
- 2021-06-08
- 2021-06-15
-
2021-08-03
Survey response — 3 months, dose 2MedDRA: Back pain, Cough, Diarrhoea, Fatigue, Influenza, Lymphadenopathy, Nasopharyngitis, Office visit, Paranasal sinus hypersecretion, SARS-CoV-2 test negative, Viral infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: loose bowels, cough, sinus drip, occasional swollen glands (throat), sore lower back, fatigueBegan after 7/4. Went to MD about 2 weeks later. Covid test negative. Dx cold/flu/virus.Still have most symptoms, though seem to be lessening.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-03
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-12
- 2021-11-02
-
2021-12-06
Dose 3 — Moderna
- 2021-12-06
- 2021-12-07
- 2021-12-08
- 2021-12-09
- 2021-12-10
- 2021-12-11
- 2021-12-12
- 2021-12-13
- 2021-12-20
- 2021-12-27
- 2022-01-03
- 2022-01-10
- 2022-01-17
- 2022-03-07
- 2022-06-06
-
2022-07-18
Dose 4 — Moderna
- 2022-07-18
- 2022-07-19
- 2022-07-20
- 2022-07-21
- 2022-07-22
- 2022-07-23
- 2022-07-24
- 2022-07-25
-
2022-08-01
Survey response — day 14, dose 4MedDRA: Aura, Visual impairment — Feeling: GoodFree text: vision issue, weird aura, both eyes, lasted ~20 minutes.MedDRA releases: 2024-11 · check-in free text available
- 2022-08-08
- 2022-08-15
- 2022-08-22
-
2022-08-29
Survey response — day 42, dose 4MedDRA: Aura — Feeling: Good · 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: Visual aura for ~60 minutes. Similar to the one I reported after one of the prior shots (which was the 1st time I'd ever had aura in my life).MedDRA releases: 2024-11 · check-in free text available
-
2022-08-29
Report sent to call center — day 42, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-08-30
Call successfulCompleted over the phone
-
2022-08-30
Call successfulCompleted over the phone
-
2022-08-30
Call successfulCompleted over the phone
- 2023-01-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-13 | Pfizer-BioNTech | |
| 2 | 2021-05-04 | Pfizer-BioNTech | |
| 3 | 2021-12-06 | Moderna | No |
| 4 | 2022-07-18 | Moderna | No |
Call center
3 call center cases
3 successful
VAERS report filed, before or during a call: 3
Free text
Release 8 — day 0, dose 2
Systemic reaction (other): Visual aura in one eye (started 3 hours after shot, lasted ~30 minutes)
Healthcare visit (other): Called re: visual aura
Release 8 — day 14, dose 2
Symptoms: Brief recurrence of eye aura in right eye. Similar to day of 2nd shot (reported via this website/ app). Lasted 5-10 minutes.
Release 9 — 3 months, dose 2
Symptoms: loose bowels, cough, sinus drip, occasional swollen glands (throat), sore lower back, fatigueBegan after 7/4. Went to MD about 2 weeks later. Covid test negative. Dx cold/flu/virus.Still have most symptoms, though seem to be lessening.
Release 12 — day 14, dose 4
Symptoms: vision issue, weird aura, both eyes, lasted ~20 minutes.
Release 12 — day 42, dose 4
Symptoms: Visual aura for ~60 minutes. Similar to the one I reported after one of the prior shots (which was the 1st time I'd ever had aura in my life).
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 | Aura | ✓ | ✓ | ✓ |
| HCVO | Medical counselling | ✓ | ✓ | ✓ |
| SD | Aura | ✓ | ✓ | ✓ |
| SD | Back pain | ✓ | · | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SD | Diarrhoea | ✓ | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Influenza | ✓ | · | ✓ |
| SD | Lymphadenopathy | ✓ | · | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Paranasal sinus hypersecretion | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | · | ✓ |
| SD | Viral infection | ✓ | · | ✓ |
| SD | Visual impairment | · | · | ✓ |
| SRO | Aura | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release