6JT-27094-74510

2 vaccinations 9 coded responses 13 check-ins 9 free-text entries 7 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 063 / CT
Registered: 2021-02-11

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-03
Dose 1 — Pfizer-BioNTech
2021-02-11
Registered in v-safe
2021-02-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-24
Dose 2 — Pfizer-BioNTech
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Panic attack — Feeling: Fair · Nausea

Free text: Dizziness and panic attacks, probably related to dementia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Delusion, Dementia, Paranoia, Pre-existing disease — Feeling: Fair

Free text: Paranoid delusions excessive. Has dementia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling, Panic attack — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Panic attacks · Healthcare visit (other): My chart text and future appt made

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Dementia, Pre-existing disease, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Panic attacks - probably connected to dementia, definitely worse than usual · Healthcare visit (other): Notes to Dr.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-03
Survey response — day 7, dose 2
MedDRA: Dementia, Hallucination, Panic attack, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Hallucinations, panic attacks much worse ( has dementia. Maybe LBD)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Survey response — day 14, dose 2
MedDRA: Anxiety — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Near Constant anxiety attacks

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Survey response — day 21, dose 2
MedDRA: Anxiety, Dementia, Fear, Medical counselling, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fear and anxiety. Worsening dementia · Healthcare visit (other): House call doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Survey response — day 28, dose 2
MedDRA: Medical counselling, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Probably Lewy Body related · Healthcare visit (other): Home dr. Visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-31
Survey response — day 35, dose 2
MedDRA: Death, Hospice care — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Passed away - but probably not from vaccine! · Healthcare visit (other): Hospice

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-30
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Pfizer-BioNTech
2	2021-02-24	Pfizer-BioNTech

Call center

7 call center cases

7 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Dizziness and panic attacks, probably related to dementia

2021-02-28

Systemic reaction (other): Paranoid delusions excessive. Has dementia

2021-03-01

Systemic reaction (other): Panic attacks

Healthcare visit (other): My chart text and future appt made

2021-03-02

Systemic reaction (other): Panic attacks - probably connected to dementia, definitely worse than usual

Healthcare visit (other): Notes to Dr.

Release 5 — day 7, dose 2

2021-03-03

Systemic reaction (other): Hallucinations, panic attacks much worse ( has dementia. Maybe LBD)

Release 5 — day 14, dose 2

2021-03-10

Symptoms: Near Constant anxiety attacks

Release 6 — day 21, dose 2

2021-03-19

Symptoms: Fear and anxiety. Worsening dementia

Healthcare visit (other): House call doctor

Release 6 — day 28, dose 2

2021-03-24

Symptoms: Probably Lewy Body related

Healthcare visit (other): Home dr. Visit

Release 6 — day 35, dose 2

Reports this person's death

2021-03-31

Symptoms: Passed away - but probably not from vaccine!

Healthcare visit (other): Hospice

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	Hospice care	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Anxiety	✓	✓	✓
SD	Death	✓	✓	✓
SD	Dementia	✓	✓	✓
SD	Fear	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Delusion	✓	✓	✓
SRO	Dementia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Hallucination	✓	✓	✓
SRO	Panic attack	✓	✓	✓
SRO	Paranoia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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