29L-14326-36826

4 vaccinations 23 coded responses 30 check-ins 23 free-text entries 0 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 104 / NY
Registered: 2021-03-18

Relationship: Self
Race: Black or African American
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

2021-03-17
Dose 1 — Pfizer-BioNTech
2021-03-18
Registered in v-safe
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Head discomfort — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: head congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Respiratory tract congestion — Feeling: Good · Chills, Headache

Free text: slight congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Slight congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Mild head congestion.

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
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-07
Dose 2 — Pfizer-BioNTech
2021-04-07
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good · Headache

Free text: congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Mild congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good · Joint pains

Free text: Mild congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Mild congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Mild congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — day 7, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Mild congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 14, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: More joint soreness, in both shoulders.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-05
Survey response — day 28, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Continued soreness, in both shoulders.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — day 35, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Continued soreness, in both shoulders.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 42, dose 2
MedDRA: Abnormal dreams, Arthralgia — Feeling: Good

Free text: 1. Continued pain in both shoulders. 2. Vivid dreams.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-07
Survey response — 3 months, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Continuing soreness in my shoulders, that I didnt have prior to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-06
Survey response — 6 months, dose 2
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Increased joint pain: shoulders, hips and knees. Ã‡

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Dose 3 — Pfizer-BioNTech
2022-04-07
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-09-21
Dose 4 — Pfizer-BioNTech
2022-10-04
Survey response — day 7, dose 4
MedDRA: Emergency care, Gait disturbance, Medical observation, Muscular weakness, Transient ischaemic attack — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: 1 day after the 12/22/21 booster I had a mini stroke. (Previously reported, with ambulance transport & overnight hospital stay.) 1 day after my 9/21/22 booster I had leg and arm weakness. After walking 15 feet to my kitchen, I laid down on its floor.

MedDRA releases: 2024-11 · check-in free text available
2022-10-06
Survey response — day 14, dose 4
MedDRA: Arthralgia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: On-going soreness in hips; on-going tiredness.

MedDRA releases: 2024-11 · check-in free text available
2022-10-12
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-20
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-10-26
Survey response — day 35, dose 4
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Soreness persisting in hips

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Survey response — day 42, dose 4
MedDRA: Arthralgia — Feeling: Fair

Free text: Sore hips ongoing.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Pfizer-BioNTech
2	2021-04-07	Pfizer-BioNTech
3	2021-12-22	Pfizer-BioNTech	No
4	2022-09-21	Pfizer-BioNTech	No

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-18

Systemic reaction (other): head congestion

2021-03-19

Systemic reaction (other): slight congestion

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Slight congestion.

2021-03-22

Systemic reaction (other): Mild head congestion.

2021-03-23

Systemic reaction (other): No

Release 7 — day 0, dose 2

2021-04-07

Systemic reaction (other): No

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): Congestion

2021-04-09

Systemic reaction (other): congestion

2021-04-10

Systemic reaction (other): Mild congestion.

2021-04-11

Systemic reaction (other): Mild congestion

2021-04-12

Systemic reaction (other): Mild congestion.

2021-04-13

Systemic reaction (other): Mild congestion.

Release 7 — day 7, dose 2

2021-04-14

Systemic reaction (other): Mild congestion.

Release 7 — day 14, dose 2

2021-04-21

Symptoms: More joint soreness, in both shoulders.

Release 8 — day 28, dose 2

2021-05-05

Symptoms: Continued soreness, in both shoulders.

Release 8 — day 35, dose 2

2021-05-12

Symptoms: Continued soreness, in both shoulders.

Release 8 — day 42, dose 2

2021-05-19

Symptoms: 1. Continued pain in both shoulders. 2. Vivid dreams.

Release 9 — 3 months, dose 2

2021-07-07

Symptoms: Continuing soreness in my shoulders, that I didnt have prior to the vaccine.

Release 10 — 6 months, dose 2

2021-10-06

Symptoms: Increased joint pain: shoulders, hips and knees. Ã‡

Release 12 — day 7, dose 4

2022-10-04

Systemic reaction (other): 1 day after the 12/22/21 booster I had a mini stroke. (Previously reported, with ambulance transport & overnight hospital stay.) 1 day after my 9/21/22 booster I had leg and arm weakness. After walking 15 feet to my kitchen, I laid down on its floor. cut off by CDC

Release 12 — day 14, dose 4

2022-10-06

Symptoms: On-going soreness in hips; on-going tiredness.

Release 12 — day 35, dose 4

2022-10-26

Symptoms: Soreness persisting in hips

Release 12 — day 42, dose 4

2022-11-03

Symptoms: Sore hips ongoing.

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	Abnormal dreams	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Fatigue	·	·	✓
SRO	Emergency care	·	·	✓
SRO	Gait disturbance	·	·	✓
SRO	Head discomfort	✓	✓	✓
SRO	Medical observation	·	·	✓
SRO	Muscular weakness	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Transient ischaemic attack	·	·	✓

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