Z4Z-27213-50547
2 vaccinations
4 coded responses
11 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 207 / MD
- Registered
- 2021-04-05
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-13
Dose 1 — Pfizer-BioNTech
-
2021-04-03
Dose 2 — Pfizer-BioNTech
-
2021-04-05
Registered in v-safe
-
2021-04-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-07
- 2021-04-11
- 2021-04-19
- 2021-04-24
- 2021-05-01
-
2021-05-11
Survey response — day 35, dose 2MedDRA: Dyspnoea — Feeling: GoodFree text: Increased Shortness of Breath.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-15
-
2021-07-04
Survey response — 3 months, dose 2MedDRA: Asthenia, Dyspnoea, Emergency care, Gait inability, Hospitalisation, Intensive care — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Shortness of breath. Weak. Unable to walk. Blood level 2. Ambulance to Hospital. Admitted to ICMU.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-04
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-08
-
2021-10-03
Survey response — 6 months, dose 2MedDRA: Full blood count abnormal, Hospitalisation, Intensive care, Transfusion — Feeling: FairFree text: ICU 07/02 - 09. Blood levels were 2.5. Required 5 units of blood. On going diagnostics to determine cause. Blood levels at critical level again 09/09. Iron infusions. Results not determined.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-15
-
2022-04-03
Survey response — 12 months, dose 2MedDRA: Fatigue, Pre-existing disease, Rotator cuff repair — Feeling: FairFree text: Had rotator cuff surgery 03/18/2022. Recovery in progress. Some fatigue. Will see ONOCOLOGY Dr 04/19/2022 to check blood levels.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-13 | Pfizer-BioNTech | |
| 2 | 2021-04-03 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-04 | Unsuccessful |
Free text
Release 8 — day 35, dose 2
Symptoms: Increased Shortness of Breath.
Release 9 — 3 months, dose 2
Symptoms: Shortness of breath. Weak. Unable to walk. Blood level 2. Ambulance to Hospital. Admitted to ICMU.
Release 9 — 6 months, dose 2
Symptoms: ICU 07/02 - 09. Blood levels were 2.5. Required 5 units of blood. On going diagnostics to determine cause. Blood levels at critical level again 09/09. Iron infusions. Results not determined.
Release 11 — 12 months, dose 2
Symptoms: Had rotator cuff surgery 03/18/2022. Recovery in progress. Some fatigue. Will see ONOCOLOGY Dr 04/19/2022 to check blood levels.
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 |
|---|---|---|---|---|
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Full blood count abnormal | · | · | ✓ |
| SD | Gait inability | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Intensive care | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rotator cuff repair | · | · | ✓ |
| SD | Transfusion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release