Z8U-12766-60867
2 vaccinations
3 coded responses
22 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 852 / AZ
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Registered in v-safe
-
2021-01-14
Dose 1 — Pfizer-BioNTech
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-23
- 2021-01-28
-
2021-02-04
Dose 2 — Pfizer-BioNTech
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-18
-
2021-02-25
Survey response — day 21, dose 2MedDRA: Hospitalisation, Pyrexia, Urinary tract infection — Feeling: GoodFree text: Admission to hospital on 2/19/21 for UTI with fever. Released 2/21/21. Receive IV antibiotics in hospital, and oral for 5 days pidt discharge.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-05-07
-
2021-08-05
Survey response — 6 months, dose 2MedDRA: Bladder cancer — Feeling: GoodFree text: Bladder Tumor pTa type. No further treatments, but will monitor with Cystoscopy every 3 months for 1 year, the every 6 months for 1 year and yearly thereafter if nor reappearance of a tumor.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2022-02-04
Survey response — 12 months, dose 2MedDRA: Hospitalisation, Penile dermatitis, Urinary tract infection pseudomonal, Urosepsis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Septic uti for pseudamonas required hospitalization. Had 2 episodes. Developed penile rash, unsuspected.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-04
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-02-07
-
2022-03-09
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Pfizer-BioNTech | |
| 2 | 2021-02-04 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-04 | Successful 2022-03-09 |
Participant prefers to complete VAERS report online |
Free text
Release 4 — day 21, dose 2
Symptoms: Admission to hospital on 2/19/21 for UTI with fever. Released 2/21/21. Receive IV antibiotics in hospital, and oral for 5 days pidt discharge.
Release 9 — 6 months, dose 2
Symptoms: Bladder Tumor pTa type. No further treatments, but will monitor with Cystoscopy every 3 months for 1 year, the every 6 months for 1 year and yearly thereafter if nor reappearance of a tumor.
Release 11 — 12 months, dose 2
Symptoms: Septic uti for pseudamonas required hospitalization. Had 2 episodes. Developed penile rash, unsuspected.
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 | Bladder cancer | ✓ | · | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Penile dermatitis | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Urinary tract infection | ✓ | ✓ | ✓ |
| SD | Urinary tract infection pseudomonal | · | · | ✓ |
| SD | Urosepsis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release