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2JE-25557-43405

4 vaccinations 4 coded responses 27 check-ins 4 free-text entries 0 call cases
Sex
Male
Age at first dose
51-55
ZIP prefix
180 / PA
Registered
2021-04-13
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
2NU-28078-16470 Child or adolescent in my care · Female · 2022-05-02

Timeline

  1. 2021-04-13
    Registered in v-safe
  2. 2021-04-13
    Dose 1 — Pfizer-BioNTech
  3. 2021-04-13
    Health check-in — day 0, dose 1
    Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  4. 2021-04-15
    Survey response — days 1–6 daily, dose 1
    MedDRA: Headache — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches
    Free text: D - 2 was terrible, headache so bad thats why I didnt do yesterdays check in.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  6. 2021-04-17
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pain — Feeling: Good · Site: Pain, Swelling
    Free text: Some soreness when raising arm where received shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-04-22
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-04-27
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-05-04
    Dose 2 — Pfizer-BioNTech
  11. 2021-05-04
    Health check-in — day 0, dose 2
    Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities
    Adult check-in
  12. 2021-05-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  13. 2021-05-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  14. 2021-05-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  15. 2021-05-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-05-12
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-05-20
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-05-25
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-06-01
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-06-08
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-06-15
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-08-05
    Survey response — 3 months, dose 2
    MedDRA: Headache, Nasal congestion, Nasopharyngitis, Oropharyngeal pain — Feeling: Fair
    Free text: Have a cold with stuffy nose, headache, sore throat. 16 yr old Daughter who is fully vaccinated (Pfizer) developed symptoms first, then passed it to me. She was swabbed, awaiting COVID test results from test done yesterday evening.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  23. 2021-11-02
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-12-15
    Dose 3 — Moderna
  25. 2022-04-28
    Dose 4 — Moderna
  26. 2022-05-02
    Survey response — days 1–6 daily, dose 4
    MedDRA: Headache, Joint stiffness, Pyrexia, Throat irritation — Feeling: Good · Site: Pain · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Day of injection I had low grade fever 100.9 stiff joints scratchy throat and terrible headache, which all subsided within about 48 hours.
    MedDRA releases: 2024-11 · check-in free text available
  27. 2022-05-04
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain · None
    Adult check-in
  28. 2022-05-05
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  29. 2022-05-19
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  30. 2022-06-09
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  31. 2022-07-30
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  32. 2023-04-28
    Health check-in — 12 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-13Pfizer-BioNTech
22021-05-04Pfizer-BioNTech
32021-12-15Moderna No
42022-04-28Moderna No

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-15

Systemic reaction (other): D - 2 was terrible, headache so bad thats why I didnt do yesterdays check in.

2021-04-17

Systemic reaction (other): Some soreness when raising arm where received shot.

Release 9 — 3 months, dose 2

2021-08-05

Symptoms: Have a cold with stuffy nose, headache, sore throat. 16 yr old Daughter who is fully vaccinated (Pfizer) developed symptoms first, then passed it to me. She was swabbed, awaiting COVID test results from test done yesterday evening.

Release 11 — days 1–6 daily, dose 4

2022-05-02

Systemic reaction (other): Day of injection I had low grade fever 100.9 stiff joints scratchy throat and terrible headache, which all subsided within about 48 hours.

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

FieldPreferred term2021-092023-042024-11
SDHeadache ✓ · ✓
SDNasal congestion ✓ · ✓
SDNasopharyngitis ✓ · ✓
SDOropharyngeal pain ✓ · ✓
SROHeadache ✓ ✓ ✓
SROJoint stiffness · · ✓
SROPain ✓ ✓ ✓
SROPyrexia · · ✓
SROThroat irritation · · ✓

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