34Z-38493-37155

4 vaccinations 15 coded responses 46 check-ins 14 free-text entries 3 call cases

Sex: Male
Age at first dose: 31-35
ZIP prefix: 100 / NY
Registered: 2020-12-18

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

Registered dependents

DKR-25617-10279 Child or adolescent in my care · Female · 2022-06-30

PNS-24931-86241 Child or adolescent in my care · Male · 2022-10-26

Timeline

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

2020-12-17
Dose 1 — Pfizer-BioNTech
2020-12-18
Registered in v-safe
2020-12-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2020-12-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-07
Dose 2 — Pfizer-BioNTech
2021-01-07
Survey response — day 21, dose 1
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-01-28
Survey response — day 21, dose 2
MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Good

Free text: Runny nose, sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — day 28, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — day 35, dose 2
MedDRA: Headache, Influenza virus test negative, Laboratory test, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative, Streptococcus test negative — 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: Symptoms: High fevers to 104 degrees persistently for 3 days, sore throat, headaches. Tested covid negative twice, influenza negative, rapid strep negative, started amoxicillin for presumed strep throat with resolution of fever. Continue to have sore throat. · Healthcare visit (other): Laboratory studies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-09
Survey response — 6 months, dose 2
MedDRA: Testicular pain — Feeling: Good

Free text: Mild testicular pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-29
Call 2 — Left Voicemail
2021-10-28
Dose 3 — Moderna
Co-administered: Flu
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain, Swelling

Free text: Mild sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Survey response — day 14, dose 3
MedDRA: Back pain, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Back pain exacerbation

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-29
Survey response — 3 months, dose 3
MedDRA: Hordeolum, Respiratory tract infection — Feeling: Fair · Be unable to work or attend school

Free text: You're respiratory tract infection last week, right eye stye last few days

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-10-28
Survey response — 12 months, dose 3
MedDRA: Back pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Back pain

MedDRA releases: 2024-11 · check-in free text available
2022-11-10
Dose 4 — Pfizer-BioNTech
2022-11-10
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-11-11
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-11-12
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness

Free text: Runny nose, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-11-13
Survey response — days 1–6 daily, dose 4
MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-11-14
Survey response — days 1–6 daily, dose 4
MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-11-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches

Adult check-in
2022-11-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · None

Adult check-in
2022-11-17
Health check-in — day 7, dose 4
Feeling: Fair · None

Adult check-in
2022-11-24
Survey response — day 14, dose 4
MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Fair

Free text: Runny nose, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-12-01
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-12-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-15
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-12-22
Survey response — day 42, dose 4
MedDRA: Chills, Cough, Oropharyngeal pain, Pyrexia, Rhinorrhoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Fever, chills, runny nose, sore throat, cough

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-23
Call 3 — Left Voicemail
2022-12-23
Call 2 — Left Voicemail
2023-05-12
Survey response — 6 months, dose 4
MedDRA: Pharyngitis streptococcal — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-05-12
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-05-15
Call 1 — Left Voicemail
2023-05-15
Call 1 — Left Voicemail
2023-05-15
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-17	Pfizer-BioNTech
2	2021-01-07	Pfizer-BioNTech
3	2021-10-28	Moderna	Flu
4	2022-11-10	Pfizer-BioNTech	No

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — day 21, dose 1

2021-01-07

Symptoms: Fatigue

Release 2 — day 21, dose 2

2021-01-28

Symptoms: Runny nose, sore throat

Release 3 — day 28, dose 2

2021-02-06

Symptoms: Sore throat

Release 4 — day 35, dose 2

2021-02-11

Symptoms: High fevers to 104 degrees persistently for 3 days, sore throat, headaches. Tested covid negative twice, influenza negative, rapid strep negative, started amoxicillin for presumed strep throat with resolution of fever. Continue to have sore throat. cut off by CDC

Healthcare visit (other): Laboratory studies

Release 9 — 6 months, dose 2

2021-07-09

Symptoms: Mild testicular pain

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): Mild sore throat

Release 10 — day 14, dose 3

2021-11-11

Symptoms: Back pain exacerbation

Release 11 — 3 months, dose 3

2022-01-29

Symptoms: You're respiratory tract infection last week, right eye stye last few days

Release 12 — 12 months, dose 3

2022-10-28

Symptoms: Back pain

Release 12 — days 1–6 daily, dose 4

2022-11-12

Systemic reaction (other): Runny nose, sore throat

2022-11-13

Systemic reaction (other): Runny nose

2022-11-14

Systemic reaction (other): Runny nose

Release 12 — day 14, dose 4

2022-11-24

Symptoms: Runny nose, sore throat

Release 12 — day 42, dose 4

2022-12-22

Symptoms: Fever, chills, runny nose, sore throat, cough

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	Laboratory test	✓	✓	✓
SD	Back pain	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hordeolum	·	·	✓
SD	Influenza virus test negative	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pharyngitis streptococcal	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract infection	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Streptococcus test negative	✓	✓	✓
SD	Testicular pain	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Rhinorrhoea	·	·	✓

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