69A-26281-06798
2 vaccinations
14 coded responses
24 check-ins
14 free-text entries
2 call cases
- Sex
- —
- Age at first dose
- 56-60
- ZIP prefix
- 920 / CA
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-28
Dose 1 — Pfizer-BioNTech
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2021-01-29
Registered in v-safe
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2021-01-29
Survey response — days 1–6 daily, dose 1MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain · Fever · Muscle or body aches · Be unable to do your normal daily activitiesFree text: Runny noseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-30
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2021-01-31
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue — Feeling: FairFree text: FatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-01
- 2021-02-02
- 2021-02-03
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2021-02-04
Survey response — day 7, dose 1MedDRA: Flatulence — Feeling: GoodFree text: FlatulenceMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Survey response — day 14, dose 1MedDRA: Breast pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: Pain in left breastMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-18
Dose 2 — Pfizer-BioNTech
- 2021-02-18
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2021-02-19
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-02-20
- 2021-02-21
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2021-02-22
Survey response — days 1–6 daily, dose 2MedDRA: Eye pruritus, Lacrimation increased, Pruritus, Self-medication — Feeling: FairFree text: Itchy watery eyes, Itchy nose and itchy face. How to take BenadrylMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-23
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2021-02-24
Survey response — days 1–6 daily, dose 2MedDRA: Dry mouth — Feeling: GoodFree text: Dry mouthMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
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2021-03-04
Survey response — day 14, dose 2MedDRA: Abdominal distension — Feeling: GoodFree text: BloatingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Survey response — day 21, dose 2MedDRA: Gastrooesophageal reflux disease — Feeling: Good · Be unable to do your normal daily activitiesFree text: Acid refluxMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Survey response — day 28, dose 2MedDRA: Tachycardia — Feeling: GoodFree text: TachycardiaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-25
Survey response — day 35, dose 2MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Acid refluxMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Survey response — day 42, dose 2MedDRA: Dysphagia, Reflux laryngitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Dysphagia; LPRMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professionalno matching call case
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2021-05-20
Survey response — 3 months, dose 2MedDRA: Blood testosterone increased — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Elevated testosterone levelMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-20
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-08-19
Survey response — 6 months, dose 2MedDRA: Gastrooesophageal reflux disease, Pre-existing disease, Tachycardia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: 2 weeks after the 2nd vaccine I was experiencing Exacerbations of my ectopic atrial tachycardia. The symptoms seem to be calming down. Additionally 2 weeks after my 2nd vaccine I was experiencing severe exacerbation of acid reflux which is resolvingMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-19
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-20
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2022-02-18
Survey response — 12 months, dose 2MedDRA: SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Positive Covid test on December 23, 2021MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Pfizer-BioNTech | |
| 2 | 2021-02-18 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-20 | Unsuccessful | Reported to VAERS voluntarily prior to GDIT contact |
| 2021-08-19 | Unsuccessful | Participant prefers to complete VAERS report online |
1 report(s) with no call case — see the timeline.
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Runny nose
Systemic reaction (other): Fatigue
Release 3 — day 7, dose 1
Systemic reaction (other): Flatulence
Release 4 — day 14, dose 1
Symptoms: Pain in left breast
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Itchy watery eyes, Itchy nose and itchy face. How to take Benadryl
Systemic reaction (other): Dry mouth
Release 5 — day 14, dose 2
Symptoms: Bloating
Release 5 — day 21, dose 2
Symptoms: Acid reflux
Release 5 — day 28, dose 2
Symptoms: Tachycardia
Release 6 — day 35, dose 2
Symptoms: Acid reflux
Release 6 — day 42, dose 2
Symptoms: Dysphagia; LPR
Release 8 — 3 months, dose 2
Symptoms: Elevated testosterone level
Release 9 — 6 months, dose 2
Symptoms: 2 weeks after the 2nd vaccine I was experiencing Exacerbations of my ectopic atrial tachycardia. The symptoms seem to be calming down. Additionally 2 weeks after my 2nd vaccine I was experiencing severe exacerbation of acid reflux which is resolving cut off by CDC
Release 11 — 12 months, dose 2
Symptoms: Positive Covid test on December 23, 2021
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 | Abdominal distension | ✓ | ✓ | ✓ |
| SD | Blood testosterone increased | ✓ | ✓ | ✓ |
| SD | Breast pain | ✓ | ✓ | ✓ |
| SD | Dysphagia | ✓ | ✓ | ✓ |
| SD | Gastrooesophageal reflux disease | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SD | Reflux laryngitis | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Tachycardia | ✓ | ✓ | ✓ |
| SRO | Dry mouth | ✓ | ✓ | ✓ |
| SRO | Eye pruritus | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Flatulence | ✓ | ✓ | ✓ |
| SRO | Lacrimation increased | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release