24P-30611-90859

2 vaccinations 12 coded responses 19 check-ins 12 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 782 / TX
Registered: 2021-03-19

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-18
Dose 1 — Pfizer-BioNTech
2021-03-19
Registered in v-safe
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Discomfort, Headache — Feeling: Fair

Free text: 2 headaches- both noticed for ~15 min while doing other stuff around the houseone in middle of forehead- one middle of top of head I dont recall how many hours apart maybe afternoon yesterday and around 11 pm- 1 am befor retiring for evening- noticeable discomfort a better phrase than pain maybe still getting used to new eyeglasses?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Neuralgia — Feeling: Good

Free text: A seldom (-not in months-not but few times total)-perhaps a nerve from above my eyeglasses left side ear piece down to point even with bottom of ear lobe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 7, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-08
Survey response — day 21, dose 1
MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Last evening, after eating at a good restaurant where I have eaten twice before, and later after a cup of instant decaf at the house, my digestive system over most of the night, cleaned/ emptied itself as if preparing for colonoscopyacidreflux?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Dose 2 — Pfizer-BioNTech
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Blood donation — Feeling: Fair · Muscle or body aches

Free text: I donated blood early this afternoon- perhaps this somehow compounded effects of the second COVID vaccine shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — day 7, dose 2
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-07-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-14
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Pfizer-BioNTech
2	2021-04-12	Pfizer-BioNTech

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): 2 headaches- both noticed for ~15 min while doing other stuff around the houseone in middle of forehead- one middle of top of head I dont recall how many hours apart maybe afternoon yesterday and around 11 pm- 1 am befor retiring for evening- noticeable discomfort a better phrase than pain maybe still getting used to new eyeglasses?

2021-03-21

Systemic reaction (other): A seldom (-not in months-not but few times total)-perhaps a nerve from above my eyeglasses left side ear piece down to point even with bottom of ear lobe

2021-03-22

Systemic reaction (other): No

2021-03-23

Systemic reaction (other): No

2021-03-24

Systemic reaction (other): No

Release 6 — day 7, dose 1

2021-03-25

Systemic reaction (other): No

Release 7 — day 21, dose 1

2021-04-08

Symptoms: Last evening, after eating at a good restaurant where I have eaten twice before, and later after a cup of instant decaf at the house, my digestive system over most of the night, cleaned/ emptied itself as if preparing for colonoscopyacidreflux?

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): No

2021-04-16

Systemic reaction (other): I donated blood early this afternoon- perhaps this somehow compounded effects of the second COVID vaccine shot

2021-04-17

Systemic reaction (other): No

2021-04-18

Systemic reaction (other): No

Release 7 — day 7, dose 2

2021-04-19

Systemic reaction (other): No

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	Gastrooesophageal reflux disease	✓	✓	✓
SRO	Blood donation	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	No adverse event	✓	✓	✓

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