Y7P-20746-55866
4 vaccinations
6 coded responses
47 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 210 / MD
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-29
Registered in v-safe
-
2021-01-29
Dose 1 — Pfizer-BioNTech
- 2021-01-29
-
2021-01-30
Survey response — days 1–6 daily, dose 1MedDRA: Blood glucose decreased, Condition aggravated, Pre-existing disease — Feeling: Fair · Muscle or body aches, Fatigue or tirednessFree text: I am a Type 1 diabetic and have had se.umusual low blood sugars tjat were hard to bring upMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-12
- 2021-02-19
-
2021-02-26
Dose 2 — Pfizer-BioNTech
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
-
2021-05-28
Survey response — 3 months, dose 2MedDRA: Pneumonia — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Pneumonia diagnosed May 20MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-08-27
Survey response — 6 months, dose 2MedDRA: Pain in extremity — Feeling: Good · Be unable to do your normal daily activitiesFree text: Bad leg pain down right side of one leg suddenly that lasted about a week. Happened the second week in AugustMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-29
Dose 3 — Pfizer-BioNTech
- 2021-10-01
- 2021-10-02
- 2021-10-03
-
2021-10-04
Survey response — days 1–6 daily, dose 3MedDRA: Dizziness, Fall — Feeling: GoodFree text: One spell of dizziness that made me fall last nightMedDRA releases: 2024-11 · check-in free text available
- 2021-10-05
- 2021-10-06
- 2021-10-13
- 2021-10-20
-
2021-10-27
Survey response — day 28, dose 3MedDRA: Pain in extremity — Feeling: Good · Be unable to do your normal daily activitiesFree text: Probably not relevant, but I have had very bad pain in one leg for a week that the doc has not yet diagnosed.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-03
- 2021-11-12
- 2021-12-29
-
2022-03-30
Survey response — 6 months, dose 3MedDRA: Arthritis, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Knee problem, arthritis · Healthcare visit (other): orthopedist and got a cortisone shotMedDRA releases: 2024-11 · check-in free text available
-
2022-03-30
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-03-31
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-04-03
Dose 4 — Moderna
- 2022-04-15
- 2022-04-17
- 2022-04-24
- 2022-05-01
- 2022-05-08
- 2022-05-15
- 2022-07-03
- 2022-10-02
- 2023-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-29 | Pfizer-BioNTech | |
| 2 | 2021-02-26 | Pfizer-BioNTech | |
| 3 | 2021-09-29 | Pfizer-BioNTech | No |
| 4 | 2022-04-03 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-30 | Successful 2022-03-31 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): I am a Type 1 diabetic and have had se.umusual low blood sugars tjat were hard to bring up
Release 8 — 3 months, dose 2
Symptoms: Pneumonia diagnosed May 20
Release 9 — 6 months, dose 2
Symptoms: Bad leg pain down right side of one leg suddenly that lasted about a week. Happened the second week in August
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): One spell of dizziness that made me fall last night
Release 10 — day 28, dose 3
Symptoms: Probably not relevant, but I have had very bad pain in one leg for a week that the doc has not yet diagnosed.
Release 11 — 6 months, dose 3
Symptoms: Knee problem, arthritis
Healthcare visit (other): orthopedist and got a cortisone shot
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 | Arthritis | · | · | ✓ |
| SD | Pain in extremity | ✓ | · | ✓ |
| SD | Pneumonia | ✓ | ✓ | ✓ |
| SRO | Blood glucose decreased | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Fall | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release