Z4B-17757-72224
4 vaccinations
8 coded responses
54 check-ins
7 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 201 / VA
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Registered in v-safe
-
2021-01-28
Dose 1 — Pfizer-BioNTech
- 2021-01-28
- 2021-01-29
-
2021-01-30
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Good · Site: RednessFree text: The redness is a brownish red and cross shapedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-31
Survey response — days 1–6 daily, dose 1MedDRA: Injection site bruising — Feeling: Good · Site: ItchingFree text: Bruising on siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-01
Survey response — days 1–6 daily, dose 1MedDRA: Contusion — Feeling: GoodFree text: Circular bruisingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-02
Survey response — days 1–6 daily, dose 1MedDRA: Injection site bruising — Feeling: GoodFree text: Ring shaped bruise around the siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-03
- 2021-02-04
- 2021-02-11
- 2021-02-18
-
2021-02-20
Dose 2 — Pfizer-BioNTech
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-03-08
-
2021-03-13
Survey response — day 21, dose 2MedDRA: Asthenia, Blood pressure decreased, Chest pain, Office visit, Pallor — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Late Wednesday night and Thursday, chest pains when breathing, esp when exhaling. A temperature of 99.9 and was feeling very weak. I was very pale. the cardiologist did an ekg and a scan. The BP dropped to 102/32. Friday I felt a bit better. Now fine · Healthcare visit (other): Primary and cardiologistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-20
- 2021-03-27
- 2021-04-04
- 2021-05-22
- 2021-08-23
-
2021-09-30
Dose 3 — Pfizer-BioNTech
- 2021-09-30
- 2021-10-01
- 2021-10-03
- 2021-10-05
- 2021-10-06
- 2021-10-07
- 2021-10-14
- 2021-10-21
- 2021-10-28
- 2021-11-04
- 2021-11-11
- 2021-12-30
- 2022-03-03
- 2022-04-03
-
2022-04-16
Dose 4 — Pfizer-BioNTech
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-22
- 2022-04-25
- 2022-04-30
- 2022-05-07
- 2022-05-14
- 2022-05-21
- 2022-05-28
-
2022-07-16
Survey response — 3 months, dose 4MedDRA: Dyspnoea — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Shortness of breath when walking fast or walking uphill.MedDRA releases: 2024-11 · check-in free text available
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2022-07-16
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-07-18
- 2022-07-18
-
2022-07-18
Call successfulNot applicable - Accidental Reporting
-
2022-07-18
Call successfulNot applicable - Accidental Reporting
-
2022-10-17
Survey response — 6 months, dose 4MedDRA: Aspiration, Dyspnoea, Hospitalisation, Pleural effusion, Pneumothorax, Thoracic operation — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Difficulty in breathing. Effusion in the chest followed by a collapsed lung and hospitalization and VATS. Now there's an aspira on the left side where the collapsed lung was.MedDRA releases: 2024-11 · check-in free text available
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2023-04-18
Survey response — 12 months, dose 4MedDRA: Dyspnoea, Pneumothorax, Surgery — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
-
2023-04-18
Report sent to call center — 12 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2023-04-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Pfizer-BioNTech | |
| 2 | 2021-02-20 | Pfizer-BioNTech | |
| 3 | 2021-09-30 | Pfizer-BioNTech | No |
| 4 | 2022-04-16 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-03-13 | Successful 2022-07-18 |
Not applicable - Accidental Reporting |
| 2022-07-16 | Successful 2022-07-18 |
Not applicable - Accidental Reporting |
| 2023-04-18 | Unsuccessful |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): The redness is a brownish red and cross shaped
Systemic reaction (other): Bruising on site
Systemic reaction (other): Circular bruising
Systemic reaction (other): Ring shaped bruise around the site
Release 5 — day 21, dose 2
Symptoms: Late Wednesday night and Thursday, chest pains when breathing, esp when exhaling. A temperature of 99.9 and was feeling very weak. I was very pale. the cardiologist did an ekg and a scan. The BP dropped to 102/32. Friday I felt a bit better. Now fine cut off by CDC
Healthcare visit (other): Primary and cardiologist
Release 12 — 3 months, dose 4
Symptoms: Shortness of breath when walking fast or walking uphill.
Release 12 — 6 months, dose 4
Symptoms: Difficulty in breathing. Effusion in the chest followed by a collapsed lung and hospitalization and VATS. Now there's an aspira on the left side where the collapsed lung was.
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 | ✓ | ✓ | ✓ |
| HCVO | Surgery | · | · | ✓ |
| SD | Aspiration | · | · | ✓ |
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Blood pressure decreased | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Pallor | ✓ | ✓ | ✓ |
| SD | Pleural effusion | · | · | ✓ |
| SD | Pneumothorax | · | · | ✓ |
| SD | Thoracic operation | · | · | ✓ |
| SRO | Contusion | ✓ | ✓ | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release