Z9X-63812-11698
4 vaccinations
6 coded responses
29 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 146 / NY
- Registered
- 2021-10-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Dose 1 — Pfizer-BioNTech
-
2021-03-24
Dose 2 — Pfizer-BioNTech
-
2021-10-07
Registered in v-safe
-
2021-10-07
Dose 3 — Pfizer-BioNTech
- 2021-10-07
-
2021-10-08
Survey response — days 1–6 daily, dose 3MedDRA: Injection site bruising, Injection site discolouration, Injection site haemorrhage, Injection site pain — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tirednessFree text: The site isn't exactly red; I have a deep purple bruise about 1"x1.5". I bled substantially from the injection - that has never happened before with any injection. It was a very painful injection, too, more so than any other injection I've had.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-09
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Redness · Headache, Fatigue or tirednessAdult check-in
- 2021-10-10
- 2021-10-11
- 2021-10-12
- 2021-10-13
- 2021-10-14
- 2021-10-21
- 2021-10-28
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2022-01-06
-
2022-04-05
Dose 4 — Pfizer-BioNTech
- 2022-04-07
-
2022-04-07
Survey response — days 1–6 daily, dose 4MedDRA: Reaction to previous exposure to any vaccine, Tinnitus — Feeling: Good · Site: Pain, Swelling · Be unable to do your normal daily activitiesFree text: Tinnitus, which I also experienced with the previous Covid-19 vaccines and boosterMedDRA releases: 2024-11 · check-in free text available
-
2022-04-08
Survey response — days 1–6 daily, dose 4MedDRA: Tinnitus — Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Muscle or body achesFree text: Tinnitus since the 2nd boosterMedDRA releases: 2024-11 · check-in free text available
-
2022-04-09
Survey response — days 1–6 daily, dose 4MedDRA: Tinnitus — Feeling: Good · Site: Pain, SwellingFree text: Tinnitus since booster, but lesseningMedDRA releases: 2024-11 · check-in free text available
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2022-04-10
Survey response — days 1–6 daily, dose 4MedDRA: Tinnitus — Feeling: GoodFree text: Residual tinnitus since boosterMedDRA releases: 2024-11 · check-in free text available
- 2022-04-11
- 2022-04-12
- 2022-04-19
- 2022-04-26
- 2022-05-03
- 2022-05-10
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2022-05-17
Survey response — day 42, dose 4MedDRA: Pruritus, Sleep disorder — Feeling: GoodFree text: Nighttime itching (nocturnal pruritis?) that is focus to my chest and intense enough that it disturbs my sleepMedDRA releases: 2024-11 · check-in free text available
- 2022-07-05
- 2022-10-04
- 2023-04-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Pfizer-BioNTech | No |
| 2 | 2021-03-24 | Pfizer-BioNTech | No |
| 3 | 2021-10-07 | Pfizer-BioNTech | No |
| 4 | 2022-04-05 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): The site isn't exactly red; I have a deep purple bruise about 1"x1.5". I bled substantially from the injection - that has never happened before with any injection. It was a very painful injection, too, more so than any other injection I've had.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Tinnitus, which I also experienced with the previous Covid-19 vaccines and booster
Systemic reaction (other): Tinnitus since the 2nd booster
Systemic reaction (other): Tinnitus since booster, but lessening
Systemic reaction (other): Residual tinnitus since booster
Release 11 — day 42, dose 4
Symptoms: Nighttime itching (nocturnal pruritis?) that is focus to my chest and intense enough that it disturbs my sleep
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 | Pruritus | · | · | ✓ |
| SD | Sleep disorder | · | · | ✓ |
| SRO | Injection site bruising | · | · | ✓ |
| SRO | Injection site discolouration | · | · | ✓ |
| SRO | Injection site haemorrhage | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Tinnitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release