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XZ8-28672-47140

3 vaccinations 5 coded responses 16 check-ins 5 free-text entries 2 call cases
Sex
Male
Age at first dose
56-60
ZIP prefix
195 / PA
Registered
2021-04-19
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-29
    Dose 1 — Pfizer-BioNTech
  2. 2021-04-19
    Registered in v-safe
  3. 2021-04-19
    Dose 2 — Pfizer-BioNTech
  4. 2021-04-19
    Health check-in — 0 day, dose 2
    Feeling: Poor · Site: Itching · Nausea, Abdominal pain, Rash, not including the immediate area around the injection site
    Adult check-in
  5. 2021-04-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  6. 2021-04-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea
    Adult check-in
  7. 2021-04-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  8. 2021-04-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-04-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Mouth ulceration — Feeling: Good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  10. 2021-04-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-04-26
    Health check-in — 7 day, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-05-03
    Survey response — 14 day, dose 2
    MedDRA: Contusion, Haemorrhage, Rash — Feeling: Good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  13. 2021-05-10
    Health check-in — 21 day, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-05-18
    Health check-in — 28 day, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-05-24
    Health check-in — 35 day, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-05-31
    Survey response — 42 day, dose 2
    MedDRA: Mouth ulceration — Feeling: Good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
  17. 2021-07-19
    Survey response — 3 month, dose 2
    MedDRA: Adverse reaction — 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 visit, Hospitalization
    MedDRA releases: 2024-11 · check-in answers available
  18. 2021-07-19
    Report sent to call center — 3 month, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    1 call case(s)
  19. 2021-07-26
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  20. 2021-10-19
    Survey response — 6 month, dose 2
    MedDRA: Vertigo — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11 · check-in answers available
  21. 2021-10-19
    Report sent to call center — 6 month, dose 2
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  22. 2021-10-21
  23. 2021-12-03
    Dose 3 — Pfizer-BioNTech
  24. 2022-12-03
    Health check-in — 12 month, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-29Pfizer-BioNTech
22021-04-19Pfizer-BioNTech
32021-12-03Pfizer-BioNTech No

Call center

ReportedOutcomeVAERS-related outcome
2021-07-19 Successful
2021-07-26
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-19 Unsuccessful

Free text

Release 7

Systemic reaction (other): Ulcers in mouth. Ive had them occasionally throughout my life but never like this. Ive never had more than 2 or 3 in the past. Today I have 8 of them seems odd.

Release 8

Symptoms: Excessive bleeding and bruises. I bled an unbelievable amount on Friday evening from very minor things and also noticed big bruises on my legs for no apparent reason. I developed a bad skin rash under my Fitbit which Ive never had before.

Symptoms: I got a mouth full of ulcers again. 2nd time now after 2nd shot. I have had maybe one or two occasionally in the past (pre vaccine-whole life). Since vaccine I have had 8 to 10 at a time in mouth and throat, on two occasions.

Release 9

Symptoms: Unknown at the moment. Was checked for lung blood clot and heart attack. Both were negative. Need to get more tests.

Release 10

Symptoms: Vertigo

Free-text releases are not linked to a specific 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
SDAdverse reaction · · ✓
SDContusion ✓ ✓ ✓
SDHaemorrhage ✓ ✓ ✓
SDMouth ulceration ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDVertigo · · ✓
SROMouth ulceration ✓ ✓ ✓

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