FU5-30567-33684
1 vaccination
3 coded responses
3 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 190 / PA
- Registered
- 2021-09-12
- Relationship
- Adult relative or friend
- Guardian
- 6SM-16389-15670
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-08-10
Dose 1 — Pfizer-BioNTech
-
2021-09-12
Registered in v-safe
-
2021-09-12
Survey response — day 28, dose 1, dependentMedDRA: Balance disorder, Chills, Decreased appetite, Fall, Fatigue, Heart valve incompetence, Hypertension, Office visit, Peripheral swelling, Psychotic disorder, Pyrexia — Feeling: Fair · Be unable to do their normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Day after swollen from thighs to feet with blood from heart valve NOW leaking, rite after dr just approved her for vaccine. Fever, chills, no appetite, total loss of balance& fell 2x, fatique& loss of reality. Extremly high blood pressure, · Healthcare visit (other): Pprimary cardiologistMedDRA releases: 2024-11 · check-in free text available
-
2021-09-12
Report sent to call center — day 28, dose 1, dependentBe unable to do their normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-09-16
Survey response — day 35, dose 1, dependentMedDRA: Atrial fibrillation, Cardiac complication associated with device, Cardiac valve prosthesis user, Echocardiogram abnormal, Hypertension, Office visit, Pre-existing disease — Feeling: Fair · Be unable to do their normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: High blood pressure& is already on 1.5mg of hctc& 100mg of metatoporol& 30mg of linsinopril& 15mg of eliquis 2x/dy. dr ordered blood work& echo shows heart value sleeve implanted during bi-pass in 2013 is leaking. Passmaker in 2016,but went into afib · Healthcare visit (other): CardiologistMedDRA releases: 2024-11 · check-in free text available
-
2021-09-16
Report sent to call center — day 35, dose 1, dependentBe unable to do their normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-20
-
2021-11-12
Survey response — 3 months, dose 1, dependentMedDRA: Blood pressure increased, Dyspnoea, Gait disturbance, Office visit, Ventricular fibrillation — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Shortness of breath-unable to walk more then 10 feet@a time now! High blood pressure except few hrs after lisinopril, metatoprol& eliquis! Going back to cardiologist AGAIN. 4TH TIME SINCE COVID VACCINATION& ventricular afibulation has worsenedMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-10 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 unsuccessful
Free text
Release 9 — day 28, dose 1, dependent
Symptoms: Day after swollen from thighs to feet with blood from heart valve NOW leaking, rite after dr just approved her for vaccine. Fever, chills, no appetite, total loss of balance& fell 2x, fatique& loss of reality. Extremly high blood pressure,
Healthcare visit (other): Pprimary cardiologist
Release 9 — day 35, dose 1, dependent
Symptoms: High blood pressure& is already on 1.5mg of hctc& 100mg of metatoporol& 30mg of linsinopril& 15mg of eliquis 2x/dy. dr ordered blood work& echo shows heart value sleeve implanted during bi-pass in 2013 is leaking. Passmaker in 2016,but went into afib cut off by CDC
Healthcare visit (other): Cardiologist
Release 10 — 3 months, dose 1, dependent
Symptoms: Shortness of breath-unable to walk more then 10 feet@a time now! High blood pressure except few hrs after lisinopril, metatoprol& eliquis! Going back to cardiologist AGAIN. 4TH TIME SINCE COVID VACCINATION& ventricular afibulation has worsened
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 | Office visit | · | · | ✓ |
| SD | Atrial fibrillation | · | · | ✓ |
| SD | Balance disorder | · | · | ✓ |
| SD | Blood pressure increased | · | · | ✓ |
| SD | Cardiac complication associated with device | · | · | ✓ |
| SD | Cardiac valve prosthesis user | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Decreased appetite | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Echocardiogram abnormal | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Gait disturbance | · | · | ✓ |
| SD | Heart valve incompetence | · | · | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Peripheral swelling | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Psychotic disorder | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Ventricular fibrillation | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release