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5RB-19535-91249

3 vaccinations 3 coded responses 3 check-ins 3 free-text entries 1 call case
Sex
Male
Age at first dose
66+
ZIP prefix
114 / NY
Registered
2021-09-06
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-05
    Dose 1 — Pfizer-BioNTech
  2. 2021-03-25
    Dose 2 — Pfizer-BioNTech
  3. 2021-09-06
    Registered in v-safe
  4. 2021-12-15
    Dose 3 — Pfizer-BioNTech
  5. 2022-03-25
    Survey response — 12 months, dose 2
    MedDRA: Back pain, Condition aggravated, Musculoskeletal chest pain, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Spinal lumbar and chest pain from the wires/bone area they used in my open heart surgery
    MedDRA releases: 2024-11 · check-in free text available
  6. 2022-03-25
    Report sent to call center — 12 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · 1 call case(s)
  7. 2022-03-28
  8. 2022-06-17
    Survey response — 6 months, dose 3
    MedDRA: Acquired diaphragmatic eventration, Aortic aneurysm, Pre-existing disease — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: abdominal aorta 3.3 x 3.0 cm. The thoracic aorta is uncoiled. Chest wall and lower neck: L.eft hemidiaphragm. elevated. Upper abdomen: Normal. Bones: Poststernotomy, with sternotomy wires present. Impression: Thoracoabdominal aortic aneurysm, measur
    MedDRA releases: 2024-11 · check-in free text available
  9. 2022-12-15
    Survey response — 12 months, dose 3
    MedDRA: Aortic aneurysm, Rotator cuff syndrome, Sciatica — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Small tear in r/rotator cuff, sciatica on right side hip, leg, knee, ankle,and uncoiled aorta
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-03-05Pfizer-BioNTech No
22021-03-25Pfizer-BioNTech No
32021-12-15Pfizer-BioNTech No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 11 — 12 months, dose 2

2022-03-25

Symptoms: Spinal lumbar and chest pain from the wires/bone area they used in my open heart surgery

Release 12 — 6 months, dose 3

2022-06-17

Symptoms: abdominal aorta 3.3 x 3.0 cm. The thoracic aorta is uncoiled. Chest wall and lower neck: L.eft hemidiaphragm. elevated. Upper abdomen: Normal. Bones: Poststernotomy, with sternotomy wires present. Impression: Thoracoabdominal aortic aneurysm, measur cut off by CDC

Release 12 — 12 months, dose 3

2022-12-15

Symptoms: Small tear in r/rotator cuff, sciatica on right side hip, leg, knee, ankle,and uncoiled aorta

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

FieldPreferred term2021-092023-042024-11
SDAcquired diaphragmatic eventration · · ✓
SDAortic aneurysm · · ✓
SDBack pain · · ✓
SDCondition aggravated · · ✓
SDMusculoskeletal chest pain · · ✓
SDPre-existing disease · · ✓
SDRotator cuff syndrome · · ✓
SDSciatica · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release