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
-
2021-03-05
Dose 1 — Pfizer-BioNTech
-
2021-03-25
Dose 2 — Pfizer-BioNTech
-
2021-09-06
Registered in v-safe
-
2021-12-15
Dose 3 — Pfizer-BioNTech
-
2022-03-25
Survey response — 12 months, dose 2MedDRA: 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 visitFree text: Spinal lumbar and chest pain from the wires/bone area they used in my open heart surgeryMedDRA releases: 2024-11 · check-in free text available
-
2022-03-25
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-03-28
-
2022-06-17
Survey response — 6 months, dose 3MedDRA: Acquired diaphragmatic eventration, Aortic aneurysm, Pre-existing disease — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree 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, measurMedDRA releases: 2024-11 · check-in free text available
-
2022-12-15
Survey response — 12 months, dose 3MedDRA: Aortic aneurysm, Rotator cuff syndrome, Sciatica — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Small tear in r/rotator cuff, sciatica on right side hip, leg, knee, ankle,and uncoiled aortaMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Pfizer-BioNTech | No |
| 2 | 2021-03-25 | Pfizer-BioNTech | No |
| 3 | 2021-12-15 | Pfizer-BioNTech | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 11 — 12 months, dose 2
Symptoms: Spinal lumbar and chest pain from the wires/bone area they used in my open heart surgery
Release 12 — 6 months, dose 3
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Acquired diaphragmatic eventration | · | · | ✓ |
| SD | Aortic aneurysm | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Musculoskeletal chest pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rotator cuff syndrome | · | · | ✓ |
| SD | Sciatica | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release