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YWR-33626-58364

3 vaccinations 3 coded responses 6 check-ins 3 free-text entries 1 call case
Sex
Male
Age at first dose
66+
ZIP prefix
370 / TN
Registered
2021-03-26
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-03
    Dose 1 — Pfizer-BioNTech
  2. 2021-03-25
    Dose 2 — Pfizer-BioNTech
  3. 2021-03-26
    Registered in v-safe
  4. 2021-03-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  5. 2021-04-30
    Survey response — day 35, dose 2
    MedDRA: Abdominal pain upper, Chills, Dizziness, Headache, Pain, Pyrexia, Respiratory tract congestion — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities
    Free text: Chills , high temperature, headaches, upper stomach pain , dizziness ,congestion and body aches.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-05-06
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  7. 2021-06-24
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in
  8. 2021-09-23
    Survey response — 6 months, dose 2
    MedDRA: Abdominal pain lower, Back pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free text: Symptoms: I do not know if it is Covid 19 or Vacinated related but I have am experiencing a pain in my mid left back that has gradually extended to my lower mid abdominal left side. Have appointment on 9/24 and will discuss. · Healthcare visit (other): 9/24 scheduled visit with my Physician .
    MedDRA releases: 2024-11 · check-in free text available
  9. 2021-09-23
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-09-27
  11. 2021-09-30
  12. 2021-11-11
    Dose 3 — Pfizer-BioNTech
  13. 2022-03-25
    Survey response — 12 months, dose 2
    MedDRA: Asthenia, Headache, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Sinus infections . Weakness no Energy . Random Headaches .
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-03-03Pfizer-BioNTech
22021-03-25Pfizer-BioNTech
32021-11-11Pfizer-BioNTech No

Call center

ReportedOutcomeVAERS-related outcome
2021-09-23 Unsuccessful

Free text

Release 8 — day 35, dose 2

2021-04-30

Symptoms: Chills , high temperature, headaches, upper stomach pain , dizziness ,congestion and body aches.

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: I do not know if it is Covid 19 or Vacinated related but I have am experiencing a pain in my mid left back that has gradually extended to my lower mid abdominal left side. Have appointment on 9/24 and will discuss.
Healthcare visit (other): 9/24 scheduled visit with my Physician .

Release 11 — 12 months, dose 2

2022-03-25

Symptoms: Sinus infections . Weakness no Energy . Random Headaches .

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
HCVOUnevaluable event · · ✓
SDAbdominal pain lower · · ✓
SDAbdominal pain upper ✓ ✓ ✓
SDAsthenia · · ✓
SDBack pain · · ✓
SDChills ✓ ✓ ✓
SDDizziness ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDRespiratory tract congestion ✓ ✓ ✓
SDSinusitis · · ✓

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