25M-21579-85602

6 vaccinations 7 coded responses 51 check-ins 7 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 117 / NY
Registered: 2021-03-05

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

2021-02-12
Dose 1 — Pfizer-BioNTech
2021-03-05
Registered in v-safe
2021-03-05
Dose 2 — Pfizer-BioNTech
2021-03-05
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Poor · Site: Pain · Chills · Be unable to do your normal daily activities

Free text: I have very bad lower back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Sciatica — Feeling: Poor · Muscle or body aches · Be unable to do your normal daily activities

Free text: I am having very bad lower Back pain in my right side going down my right leg. The second vaccine shot may be aggravating an existing condition of sciatica

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Movement disorder — Feeling: Fair · Muscle or body aches

Free text: My lower right side back pain has subsided, and I can move around much better today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Flank pain, Pain in extremity, Sciatica — Feeling: Fair · Muscle or body aches

Free text: I have some pain to my lower right side and down my right leg. Sciatic pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Pain in extremity — Feeling: Fair · Joint pains

Free text: I have pain to my lower back and sciatic nerve going down my right leg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-18
Dose 3 — Pfizer-BioNTech
2021-09-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-02
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-11-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-02-04
Dose 4 — Pfizer-BioNTech
2022-02-06
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Pain · Fever · Muscle or body aches

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-02-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-02-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-02-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-02-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-02-11
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-02-18
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-02-25
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-03-04
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-03-11
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-03-18
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-05-06
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-08-05
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-09-28
Dose 5 — Moderna
2022-09-28
Survey response — day 0, dose 5
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Fever · Joint pains, Fatigue or tiredness

Adult check-in
2022-09-30
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-01
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-02
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-03
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-04
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-05
Health check-in — day 7, dose 5
Feeling: Poor · Fever · Chills, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-10-12
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-19
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-26
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-09
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-28
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-29
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in
2023-04-26
Dose 6 — Pfizer-BioNTech
2023-05-08
Health check-in — day 7, dose 6
Feeling: Good · None

Adult check-in
2023-05-10
Health check-in — day 14, dose 6
Feeling: Good

Adult check-in
2023-05-17
Health check-in — day 21, dose 6
Feeling: Good

Adult check-in
2023-05-24
Health check-in — day 28, dose 6
Feeling: Good

Adult check-in
2023-05-31
Health check-in — day 35, dose 6
Feeling: Good

Adult check-in
2023-06-07
Health check-in — day 42, dose 6
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Pfizer-BioNTech
2	2021-03-05	Pfizer-BioNTech
3	2021-08-18	Pfizer-BioNTech	No
4	2022-02-04	Pfizer-BioNTech	No
5	2022-09-28	Moderna	No
6	2023-04-26	Pfizer-BioNTech	No

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): I have very bad lower back pain

2021-03-07

Systemic reaction (other): I am having very bad lower Back pain in my right side going down my right leg. The second vaccine shot may be aggravating an existing condition of sciatica

2021-03-08

Systemic reaction (other): My lower right side back pain has subsided, and I can move around much better today

2021-03-09

Systemic reaction (other): I have some pain to my lower right side and down my right leg. Sciatic pain.

2021-03-10

Systemic reaction (other): I have pain to my lower back and sciatic nerve going down my right leg

Release 11 — days 1–6 daily, dose 4

2022-02-06

Systemic reaction (other): No

Release 12 — day 0, dose 5

2022-09-28

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
SRO	Back pain	✓	✓	✓
SRO	Flank pain	✓	·	✓
SRO	Movement disorder	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Sciatica	✓	✓	✓

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