6W8-30760-00107
4 vaccinations
5 coded responses
28 check-ins
5 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 107 / NY
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-17
Dose 1 — Pfizer-BioNTech
-
2021-01-20
Registered in v-safe
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-31
-
2021-02-06
Dose 2 — Pfizer-BioNTech
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-12
- 2021-02-13
-
2021-02-20
Survey response — day 14, dose 2MedDRA: Decreased appetite, Medical counselling, Night sweats, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: 6 days following my second dose I developed an occasional low fever (although one time it reached 102.6 in the middle of the night), and loss of appetite. I also suffered night sweats. I got better on the third day. I am negative for Covid-19. · Healthcare visit (other): My doctor ran numerous blood tests and has scheduled a PET scan for next week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-20
Report sent to call center — day 14, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-28
- 2021-03-06
- 2021-03-13
-
2021-03-20
Survey response — day 42, dose 2MedDRA: No adverse event — Feeling: FairFree text: Unrelated to the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-08
-
2021-08-07
Survey response — 6 months, dose 2MedDRA: Follicular lymphoma — Feeling: GoodFree text: I have been diagnosed with Follicular Lymphoma and I've been treated for it with Rituxan. The treatment knocked out my Covid anti-bodies. I need either a booster shot or a full repeat vaccination. But the CDC has not approved any form of booster.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-16
Dose 3 — Pfizer-BioNTech
-
2021-08-16
Call successfulParticipant prefers to complete VAERS report online
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2022-02-06
Survey response — 12 months, dose 2MedDRA: Oropharyngeal pain, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: On January I, 2022, I tested positive for COVID-19 - with an awful sore throat.MedDRA releases: 2024-11 · check-in free text available
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2022-02-06
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
- 2022-02-07
-
2022-02-07
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-02-14
Survey response — 6 months, dose 3MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: I had Covid19MedDRA releases: 2024-11 · check-in free text available
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2022-02-14
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
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2022-02-16
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-05-06
Dose 4 — Pfizer-BioNTech
- 2022-05-14
- 2022-05-21
- 2022-05-27
- 2022-06-06
- 2022-06-10
- 2022-06-18
- 2022-08-05
- 2022-11-04
- 2023-05-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-17 | Pfizer-BioNTech | |
| 2 | 2021-02-06 | Pfizer-BioNTech | |
| 3 | 2021-08-16 | Pfizer-BioNTech | No |
| 4 | 2022-05-06 | Pfizer-BioNTech | No |
Call center
3 call center cases
3 successful
Free text
Release 4 — day 14, dose 2
Symptoms: 6 days following my second dose I developed an occasional low fever (although one time it reached 102.6 in the middle of the night), and loss of appetite. I also suffered night sweats. I got better on the third day. I am negative for Covid-19.
Healthcare visit (other): My doctor ran numerous blood tests and has scheduled a PET scan for next week.
Release 6 — day 42, dose 2
Symptoms: Unrelated to the vaccine.
Release 9 — 6 months, dose 2
Symptoms: I have been diagnosed with Follicular Lymphoma and I've been treated for it with Rituxan. The treatment knocked out my Covid anti-bodies. I need either a booster shot or a full repeat vaccination. But the CDC has not approved any form of booster. cut off by CDC
Release 11 — 12 months, dose 2
Symptoms: On January I, 2022, I tested positive for COVID-19 - with an awful sore throat.
Release 11 — 6 months, dose 3
Symptoms: I had Covid19
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 | Medical counselling | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Decreased appetite | ✓ | ✓ | ✓ |
| SD | Follicular lymphoma | ✓ | · | ✓ |
| SD | Night sweats | ✓ | ✓ | ✓ |
| SD | No adverse event | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release