259-18571-24527

6 vaccinations 11 coded responses 19 check-ins 10 free-text entries 7 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 946 / CA
Registered: 2021-03-08

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

2021-02-04
Dose 1 — Pfizer-BioNTech
2021-03-08
Registered in v-safe
2021-03-08
Survey response — day 28, dose 1
MedDRA: Full blood count abnormal, Platelet count decreased, Thrombocytopenia — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: No immediate side effects I could feel. Same was true over next 24 hrs. However, less than 24 hrs I had a CBC & my platelets fell from 403 to 197 to ~87. On Feb 11 I was admitted to CPMC with initially diagnosed Thrombocytopenia. However, it rapidly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Report sent to call center — day 28, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-13
Survey response — day 35, dose 1
MedDRA: SARS-CoV-2 test, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Yesterday morning, had scheduled retrograde at CPMC in SF. Have a Foley catheter thats a little uncomfortable. Other than tat feeling better and was able to do all my normal morning excess with our aid/PT person. · Healthcare visit (other): Last Monday, my wife drove me to (b)(6) for the battery of pre-op tests. Among those was the Roche COBAS SARS-CoV-2 TaqMan RT-PCR test. The results on Tuesday, were Not Detected.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Report sent to call center — day 35, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-20
Survey response — day 42, dose 1
MedDRA: Bladder catheterisation, Bladder operation, Cystogram — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Retrograde Bladder surgery; Foley Catheter for 4 days. Doing AOK

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Report sent to call center — day 42, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Dose 2 — Pfizer-BioNTech
2021-05-06
Health check-in — 3 months, dose 1
Feeling: Fair

Adult check-in
2021-08-05
Survey response — 6 months, dose 1
MedDRA: Basal cell carcinoma, Micrographic skin surgery, Renal transplant, Squamous cell carcinoma — Feeling: Good

Free text: More SCC & BCC. All removed by Mhos surgery. No infectious or symptoms re COVID-19. Being very careful, wearing 2 layer mask whenever outside of home, no public transport etc. Im an immunosuppressed kidney Tx recipient. No booster yet?

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-19
Dose 3 — Pfizer-BioNTech
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Urinary tract infection — Feeling: Good

Free text: UTI. Cured

MedDRA releases: 2024-11 · check-in free text available
2021-09-30
Survey response — day 42, dose 3
MedDRA: Basal cell carcinoma, Cancer surgery, Skin neoplasm excision, Squamous cell carcinoma — Feeling: Good

Free text: More SCC & BCC. ALL REMOVED

MedDRA releases: 2024-11 · check-in free text available
2021-10-18
Call 1 — Could Not Reach Participant
2021-10-21
Call 2 — Could Not Reach Participant
2021-11-16
Dose 4 — Moderna
Co-administered: Other
2021-11-18
Survey response — 3 months, dose 3
MedDRA: Joint dislocation, Pre-existing disease, Shoulder fracture, Stress fracture, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Dislocated & hairline fracture of right shoulder 3 weeks. Had shoulder relocated but only after 5-6 hrs. Cystoscope or bladder 1 week ago. As immunosuppressed kidney TC pt. with very low or no humoral or T-cell immunity to SARS-CoV-2 following 2 P · Healthcare visit (other): Moderna full dose 2 days ago

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-11-19
Call 1 — Left Voicemail
2022-02-09
Dose 5 — Moderna
2022-02-17
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-02-17
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-05-17
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2022-05-17
Survey response — 6 months, dose 4
MedDRA: Micrographic skin surgery, Office visit, Pre-existing disease, Squamous cell carcinoma — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Had seven (!) SCC's removed. Likely due to mu immunosuppressed status (Kidney Tx receipient). · Healthcare visit (other): Moh's surgery dermatological surgeon

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-18
Call successful
Not applicable - Accidental Reporting
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-10
Survey response — 6 months, dose 5
MedDRA: Hypoaesthesia, Neuropathy peripheral, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Bilateral ulna nerve neuropathy. It affects the outside of both my palms causing numbness. · Healthcare visit (other): Saw both my neurologist for Dx & and a surgical neurologist.

MedDRA releases: 2024-11 · check-in free text available
2022-08-10
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2022-08-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-10
Dose 6 — Moderna
Co-administered: Flu
2022-10-06
Health check-in — day 21, dose 6
Feeling: Good

Adult check-in
2022-10-08
Health check-in — day 28, dose 6
Feeling: Good

Adult check-in
2022-10-15
Health check-in — day 35, dose 6
Feeling: Good

Adult check-in
2022-10-22
Survey response — day 42, dose 6
MedDRA: Office visit, Pain in jaw — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sore left mandibular joint. Not tooth involvement or anything seen seen by ultrasound. Went for c-rays this am. Results Later today.

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Report sent to call center — day 42, dose 6
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-26
Call successful
Not applicable - Accidental Reporting
2022-12-10
Health check-in — 3 months, dose 6
Feeling: Good

Adult check-in
2023-03-11
Survey response — 6 months, dose 6
MedDRA: Pre-existing disease — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Pfizer-BioNTech
2	2021-03-25	Pfizer-BioNTech	No
3	2021-08-19	Pfizer-BioNTech	No
4	2021-11-16	Moderna	Other
5	2022-02-09	Moderna	No
6	2022-09-10	Moderna	Flu

Call center

7 call center cases

7 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — day 28, dose 1

2021-03-08

Symptoms: No immediate side effects I could feel. Same was true over next 24 hrs. However, less than 24 hrs I had a CBC & my platelets fell from 403 to 197 to ~87. On Feb 11 I was admitted to CPMC with initially diagnosed Thrombocytopenia. However, it rapidly cut off by CDC

Release 5 — day 35, dose 1

2021-03-13

Symptoms: Yesterday morning, had scheduled retrograde at CPMC in SF. Have a Foley catheter thats a little uncomfortable. Other than tat feeling better and was able to do all my normal morning excess with our aid/PT person.

Healthcare visit (other): Last Monday, my wife drove me to (b)(6) for the battery of pre-op tests. Among those was the Roche COBAS SARS-CoV-2 TaqMan RT-PCR test. The results on Tuesday, were Not Detected.

redacted (b)(6)

Release 6 — day 42, dose 1

2021-03-20

Symptoms: Retrograde Bladder surgery; Foley Catheter for 4 days. Doing AOK

Release 9 — 6 months, dose 1

2021-08-05

Symptoms: More SCC & BCC. All removed by Mhos surgery. No infectious or symptoms re COVID-19. Being very careful, wearing 2 layer mask whenever outside of home, no public transport etc. Im an immunosuppressed kidney Tx recipient. No booster yet?

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: UTI. Cured

Release 9 — day 42, dose 3

2021-09-30

Symptoms: More SCC & BCC. ALL REMOVED

Release 10 — 3 months, dose 3

2021-11-18

Symptoms: Dislocated & hairline fracture of right shoulder 3 weeks. Had shoulder relocated but only after 5-6 hrs. Cystoscope or bladder 1 week ago. As immunosuppressed kidney TC pt. with very low or no humoral or T-cell immunity to SARS-CoV-2 following 2 P cut off by CDC

Healthcare visit (other): Moderna full dose 2 days ago

Release 11 — 6 months, dose 4

2022-05-17

Symptoms: Had seven (!) SCC's removed. Likely due to mu immunosuppressed status (Kidney Tx receipient).

Healthcare visit (other): Moh's surgery dermatological surgeon

Release 12 — 6 months, dose 5

2022-08-10

Symptoms: Bilateral ulna nerve neuropathy. It affects the outside of both my palms causing numbness.

Healthcare visit (other): Saw both my neurologist for Dx & and a surgical neurologist.

Release 12 — day 42, dose 6

2022-10-22

Symptoms: Sore left mandibular joint. Not tooth involvement or anything seen seen by ultrasound. Went for c-rays this am. Results Later today.

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
HCVO	Micrographic skin surgery	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	SARS-CoV-2 test	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Basal cell carcinoma	✓	·	✓
SD	Bladder catheterisation	✓	✓	✓
SD	Bladder operation	·	·	✓
SD	Cancer surgery	·	·	✓
SD	Cystogram	✓	✓	○
SD	Full blood count abnormal	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Immunosuppressant drug therapy	○	·	○
SD	Joint dislocation	·	·	✓
SD	Micrographic skin surgery	✓	·	✓
SD	Neuropathy peripheral	·	·	✓
SD	Office visit	·	·	✓
SD	Pain in jaw	·	·	✓
SD	Platelet count decreased	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Renal transplant	✓	·	✓
SD	Shoulder fracture	·	·	✓
SD	Skin neoplasm excision	·	·	✓
SD	Squamous cell carcinoma	✓	·	✓
SD	Stress fracture	·	·	✓
SD	Thrombocytopenia	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SD	Urinary tract infection	·	·	✓

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