6EA-29016-16164
4 vaccinations
3 coded responses
23 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 133 / NY
- Registered
- 2021-01-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-07
Dose 1 — Pfizer-BioNTech
-
2021-01-09
Registered in v-safe
- 2021-01-09
- 2021-01-10
-
2021-01-11
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Self-medication — Feeling: Good · HeadacheFree text: I have had a very mild headache every day since I received the vaccine. I have needed to take Tylenol on two occasions.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-21
-
2021-01-28
Dose 2 — Pfizer-BioNTech
-
2021-02-04
Health check-in — day 7, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
- 2021-02-13
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-04-29
- 2021-07-29
-
2021-10-27
Dose 3 — Pfizer-BioNTech
- 2022-01-28
-
2022-04-01
Dose 4 — Moderna
-
2022-04-22
Survey response — day 21, dose 4MedDRA: Muscle spasms, Myalgia, Pain, Pain in extremity — Feeling: Good · Be unable to do your normal daily activitiesFree text: Since after shot number 2 I have had pain in left arm. It's positional, spasm-like, intermittent, and muscular in nature. Pain is between shoulder and elbow.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-29
- 2022-05-06
- 2022-05-13
-
2022-07-01
Survey response — 3 months, dose 4MedDRA: Cough, Fatigue, Nasal congestion, Oropharyngeal pain, SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Good · Be unable to do your normal daily activitiesFree text: Upper respiratory infection for 10 days. No fever. Cough, sore throat, stuffy nose, fatigue. Negative Covid tests x-5, negative covid PCRMedDRA releases: 2024-11 · check-in free text available
- 2022-09-30
- 2023-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Pfizer-BioNTech | |
| 2 | 2021-01-28 | Pfizer-BioNTech | |
| 3 | 2021-10-27 | Pfizer-BioNTech | No |
| 4 | 2022-04-01 | Moderna | No |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): I have had a very mild headache every day since I received the vaccine. I have needed to take Tylenol on two occasions.
Release 11 — day 21, dose 4
Symptoms: Since after shot number 2 I have had pain in left arm. It's positional, spasm-like, intermittent, and muscular in nature. Pain is between shoulder and elbow.
Release 12 — 3 months, dose 4
Symptoms: Upper respiratory infection for 10 days. No fever. Cough, sore throat, stuffy nose, fatigue. Negative Covid tests x-5, negative covid PCR
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 | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release