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6JY-29269-15946

2 vaccinations 13 coded responses 13 check-ins 13 free-text entries 0 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
967 / HI
Registered
2021-07-26
Relationship
Self
Race
Multiracial
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-07-26
    Registered in v-safe
  2. 2021-07-26
    Dose 1 — Pfizer-BioNTech
  3. 2021-07-26
    Survey response — day 0, dose 1
    MedDRA: Dizziness, Product after taste — Feeling: Poor · Site: Itching · Headache · Be unable to do your normal daily activities
    Free text: Very light headiness, taste the medication in my mouth for several hours
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  4. 2021-07-28
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dysgeusia — Feeling: Poor · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Metallic taste in mouth
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  5. 2021-07-30
    Survey response — days 1–6 daily, dose 1
    MedDRA: Decreased appetite, Dysgeusia — Feeling: Poor · Site: Pain · Be unable to do your normal daily activities
    Free text: Metallic medicine taste in mouth and tongue, & no appetite
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  6. 2021-07-31
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dysgeusia, Pain — Feeling: Fair · Site: Pain · Headache, Nausea · Be unable to do your normal daily activities
    Free text: Metallic taste still in mouth and tongue.Intermittent sharp pain in varies parts of body,
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  7. 2021-08-01
    Survey response — days 1–6 daily, dose 1
    MedDRA: Decreased appetite, Dysgeusia, Headache, Pain, Taste disorder — Feeling: Fair · Headache · Be unable to do your normal daily activities
    Free text: Metallic medicine taste in mouth and on tongue, intermittent pain in various places on body and back of head, no appetite still (b)(6)
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  8. 2021-08-02
    Survey response — day 7, dose 1
    MedDRA: Muscle spasms — Feeling: Poor · Site: Pain · Be unable to do your normal daily activities
    Free text: Leg cramps
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  9. 2021-08-09
    Survey response — day 14, dose 1
    MedDRA: Headache, Product after taste, Thirst — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Medicine taste on tongue constantly intermittent sharp headaches different parts of the headExtreme thirst
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  10. 2021-08-16
    Dose 2 — Pfizer-BioNTech
  11. 2021-09-01
    Survey response — day 14, dose 2
    MedDRA: Arthralgia, Dysgeusia, Insomnia, Memory impairment, Thirst — Feeling: Fair · Be unable to do your normal daily activities
    Free text: #NAME?
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  12. 2021-09-07
    Survey response — day 21, dose 2
    MedDRA: Abdominal pain upper, Chest pain, Dysgeusia, Headache, Palpitations, Taste disorder — Feeling: Fair · Be unable to do your normal daily activities
    Free text: CONSTANT Metallic medicine taste, palpitations & intermittent chest pain, intermittent left & right upper QUANTRANT pain, more on right. and frequent headaches
    MedDRA releases: 2024-11 · check-in free text available
  13. 2021-09-15
    Survey response — day 28, dose 2
    MedDRA: Arthralgia, Dry mouth, Palpitations — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Constant dry mouth, heart palpitations and joint pains which I never did have
    MedDRA releases: 2024-11 · check-in free text available
  14. 2021-09-22
    Survey response — day 35, dose 2
    MedDRA: Headache, Hypertension, Neck pain, Oropharyngeal pain, Sensation of foreign body, Thirst — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Constant neck pain with Sore throat. Feels like a nodule in my throatConstant thirstSharp head painHypertension
    MedDRA releases: 2024-11 · check-in free text available
  15. 2021-11-15
    Survey response — 3 months, dose 2
    MedDRA: Chest pain, Cough, General physical health deterioration, Headache, Palpitations — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Intermittent Sharp head pain, lots of chest pain, coughs, palpitations I definitely know that since taking this vaccination my health has gone from excellent to poor.
    MedDRA releases: 2024-11 · check-in free text available
  16. 2022-08-16
    Survey response — 12 months, dose 2
    MedDRA: Productive cough — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Coughing up plenty phlegm
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-07-26Pfizer-BioNTech No
22021-08-16Pfizer-BioNTech No

Free text

Release 9 — day 0, dose 1

2021-07-26

Systemic reaction (other): Very light headiness, taste the medication in my mouth for several hours

Release 9 — days 1–6 daily, dose 1

2021-07-28

Systemic reaction (other): Metallic taste in mouth

2021-07-30

Systemic reaction (other): Metallic medicine taste in mouth and tongue, & no appetite

2021-07-31

Systemic reaction (other): Metallic taste still in mouth and tongue.Intermittent sharp pain in varies parts of body,

2021-08-01

Systemic reaction (other): Metallic medicine taste in mouth and on tongue, intermittent pain in various places on body and back of head, no appetite still (b)(6)
redacted (b)(6)

Release 9 — day 7, dose 1

2021-08-02

Systemic reaction (other): Leg cramps

Release 9 — day 14, dose 1

2021-08-09

Symptoms: Medicine taste on tongue constantly intermittent sharp headaches different parts of the headExtreme thirst

Release 9 — day 14, dose 2

2021-09-01

Symptoms: #NAME?

Release 9 — day 21, dose 2

2021-09-07

Symptoms: CONSTANT Metallic medicine taste, palpitations & intermittent chest pain, intermittent left & right upper QUANTRANT pain, more on right. and frequent headaches

Release 9 — day 28, dose 2

2021-09-15

Symptoms: Constant dry mouth, heart palpitations and joint pains which I never did have

Release 9 — day 35, dose 2

2021-09-22

Symptoms: Constant neck pain with Sore throat. Feels like a nodule in my throatConstant thirstSharp head painHypertension

Release 10 — 3 months, dose 2

2021-11-15

Symptoms: Intermittent Sharp head pain, lots of chest pain, coughs, palpitations I definitely know that since taking this vaccination my health has gone from excellent to poor.

Release 12 — 12 months, dose 2

2022-08-16

Symptoms: Coughing up plenty phlegm

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
SDAbdominal pain upper · · ✓
SDArthralgia ✓ · ✓
SDChest pain · · ✓
SDCough · · ✓
SDDry mouth · · ✓
SDDysgeusia ✓ · ✓
SDGeneral physical health deterioration · · ✓
SDHeadache ✓ · ✓
SDHypertension · · ✓
SDInsomnia ✓ · ✓
SDMemory impairment ✓ · ✓
SDNeck pain · · ✓
SDOropharyngeal pain · · ✓
SDPalpitations · · ✓
SDProduct after taste ✓ · ✓
SDProductive cough · · ✓
SDSensation of foreign body · · ✓
SDTaste disorder · · ✓
SDThirst ✓ · ✓
SRODecreased appetite ✓ · ✓
SRODizziness ✓ · ✓
SRODysgeusia ✓ · ✓
SROHeadache ✓ · ✓
SROMuscle spasms ✓ · ✓
SROPain ✓ · ✓
SROProduct after taste ✓ · ✓
SROTaste disorder ✓ · ✓

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

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