24R-21722-69930

5 vaccinations 12 coded responses 46 check-ins 11 free-text entries 2 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 804 / CO
Registered: 2021-04-01

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

Timeline

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

2021-03-16
Dose 1 — Pfizer-BioNTech
2021-04-01
Registered in v-safe
2021-04-01
Survey response — day 14, dose 1
MedDRA: Pain in extremity — Feeling: Good

Free text: Sore arm for 2 days post-vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Dose 2 — Pfizer-BioNTech
2021-04-06
Health check-in — day 0, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Diarrhea, Abdominal pain

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-06
Survey response — 3 months, dose 2
MedDRA: Gastrointestinal disorder — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Gastrointestinal distress, have not been eating much at all for last week

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-21
Call 2 — Could Not Reach Participant
2021-10-05
Survey response — 6 months, dose 2
MedDRA: Asthenia, Lymphadenopathy, Somnolence, Tonsillar hypertrophy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Swollen tonsils and neck-area lymph nodes. Low energy, need for more sleep than usual

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Dose 3 — Moderna
2021-12-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-13
Survey response — days 1–6 daily, dose 3
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: shortness of breath, difficulty taking full breath

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — day 7, dose 3
MedDRA: Furuncle, Inflammation — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: inflammation in tooth, sinus, bronchi, gut (somewhere), boil near anus

MedDRA releases: 2024-11 · check-in free text available
2021-12-21
Survey response — day 14, dose 3
MedDRA: Cough, Dyspnoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cough, shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Survey response — day 21, dose 3
MedDRA: Cough, Decreased appetite, Dyspnoea, Fatigue, Headache, Oxygen saturation decreased — Feeling: Poor · Be unable to do your normal daily activities

Free text: Coughing, fatigue, loss of appetite, headache, shortness of breath, SPO2<90

MedDRA releases: 2024-11 · check-in free text available
2022-01-04
Survey response — day 28, dose 3
MedDRA: Bronchitis, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Bronchitis, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-18
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-08
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-09
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-06-10
Dose 4 — Moderna
2022-06-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-17
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-06-24
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-07-01
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-07-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-15
Survey response — day 35, dose 4
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-07-22
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-09-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-14
Dose 5 — Moderna
Co-administered: Flu
2022-09-22
Health check-in — day 7, dose 5
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-28
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-10-05
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-12
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-21
Survey response — day 35, dose 5
MedDRA: Cough, Paranasal sinus hypersecretion — Feeling: Good

Free text: Cough, sinus drainage

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Survey response — day 42, dose 5
MedDRA: Cough, Sneezing — Feeling: Good

Free text: Occasional cough, sneezing

MedDRA releases: 2024-11 · check-in free text available
2022-12-14
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-15
Survey response — 6 months, dose 5
MedDRA: Bronchitis, Cough, Malaise, Pyrexia — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-15
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-16
Call 1 — Left Voicemail
2023-03-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Pfizer-BioNTech
2	2021-04-06	Pfizer-BioNTech
3	2021-12-07	Moderna	No
4	2022-06-10	Moderna	No
5	2022-09-14	Moderna	Flu

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 6 — day 14, dose 1

2021-04-01

Symptoms: Sore arm for 2 days post-vaccine

Release 9 — 3 months, dose 2

2021-07-06

Symptoms: Gastrointestinal distress, have not been eating much at all for last week

Release 10 — 6 months, dose 2

2021-10-05

Symptoms: Swollen tonsils and neck-area lymph nodes. Low energy, need for more sleep than usual

Release 10 — days 1–6 daily, dose 3

2021-12-13

Systemic reaction (other): shortness of breath, difficulty taking full breath

Release 10 — day 7, dose 3

2021-12-14

Systemic reaction (other): inflammation in tooth, sinus, bronchi, gut (somewhere), boil near anus

Release 10 — day 14, dose 3

2021-12-21

Symptoms: Cough, shortness of breath

Release 10 — day 21, dose 3

2021-12-28

Symptoms: Coughing, fatigue, loss of appetite, headache, shortness of breath, SPO2<90

Release 10 — day 28, dose 3

2022-01-04

Symptoms: Bronchitis, fatigue

Release 12 — day 35, dose 4

2022-07-15

Symptoms: Fatigue

Release 12 — day 35, dose 5

2022-10-21

Symptoms: Cough, sinus drainage

Release 12 — day 42, dose 5

2022-10-28

Symptoms: Occasional cough, sneezing

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	Bronchitis	·	·	✓
SD	Cough	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Headache	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Malaise	·	·	✓
SD	Oxygen saturation decreased	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	Pyrexia	·	·	✓
SD	Sneezing	·	·	✓
SD	Somnolence	·	·	✓
SD	Tonsillar hypertrophy	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Furuncle	·	·	✓
SRO	Inflammation	·	·	✓

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