3PV-34164-30127

5 vaccinations 12 coded responses 43 check-ins 11 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 045 / ME
Registered: 2021-02-15

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

Registered dependents

26Z-68239-52021 Child or adolescent in my care · Male · 2021-10-01

BR6-21373-80288 Adult relative or friend · Female · 2021-10-01

Timeline

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

2021-01-25
Dose 1 — Pfizer-BioNTech
2021-02-15
Registered in v-safe
2021-02-15
Dose 2 — Pfizer-BioNTech
2021-02-15
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Blood pressure increased — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: BP last night 127/102, pulse 84. Normal = 115/69, 79 back to normal this AM.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: I mainly feel foggy brained and as though I am wading neck deep in molasses

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Feeling abnormal — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Foggy brain, weary

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Just feeling off, not sick not well. Just blah

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-08
Survey response — day 21, dose 2
MedDRA: Arthralgia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint aches, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-22
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-16
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-14
Dose 3 — Pfizer-BioNTech
2022-02-15
Survey response — 12 months, dose 2
MedDRA: Weight decreased — Feeling: Fair

Free text: Unusual weight loss

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Dose 4 — Pfizer-BioNTech
2022-05-02
Survey response — day 0, dose 4
MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Aches, pains & fatigue are chronic NOT RELATED TO THE Vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Swelling, Itching · None

Adult check-in
2022-05-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2022-05-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · None

Adult check-in
2022-05-09
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-16
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-23
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-30
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-06-06
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-13
Survey response — day 42, dose 4
MedDRA: Fluid retention, Peripheral swelling — Feeling: Poor

Free text: Leg swelling, fluid retention

MedDRA releases: 2024-11 · check-in free text available
2022-08-01
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-20
Dose 5 — Pfizer-BioNTech
2022-10-21
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2022-10-22
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-23
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-10-24
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-25
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · None

Adult check-in
2022-10-26
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · None

Adult check-in
2022-10-27
Health check-in — day 7, dose 5
Feeling: Fair · None

Adult check-in
2022-11-03
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-10
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-17
Survey response — day 28, dose 5
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Poor

Free text: A very bad cold. Covid test negative

MedDRA releases: 2024-11 · check-in free text available
2022-11-24
Survey response — day 35, dose 5
MedDRA: Acute respiratory failure, Hospitalisation, Respiratory syncytial virus infection — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: RSV. Acute respiratory failure with hypoxia. Admitted to (b)(6) Hospital 11/18 - 11/20

MedDRA releases: 2024-11 · check-in free text available
2022-11-24
Report sent to call center — day 35, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-11-25
Call 2 — Left Voicemail
2022-12-01
Survey response — day 42, dose 5
MedDRA: Cough, Fatigue, Hypoxia, Office visit — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Hypoxia, nonproductive cough, fatigue · Healthcare visit (other): Office visit with PCP

MedDRA releases: 2024-11 · check-in free text available
2022-12-01
Report sent to call center — day 42, dose 5
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-12-02
Call 3 — Left Voicemail
2022-12-02
Call 2 — Left Voicemail
2023-01-19
Survey response — 3 months, dose 5
MedDRA: Hypoxia, Respiratory syncytial virus infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11
2023-01-19
Report sent to call center — 3 months, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2023-01-20
Call 1 — Left Voicemail
2023-01-20
Call 1 — Left Voicemail
2023-01-20
Call 1 — Left Voicemail
2023-04-20
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-25	Pfizer-BioNTech
2	2021-02-15	Pfizer-BioNTech
3	2021-10-14	Pfizer-BioNTech	No
4	2022-05-02	Pfizer-BioNTech	No
5	2022-10-20	Pfizer-BioNTech	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-16

Systemic reaction (other): BP last night 127/102, pulse 84. Normal = 115/69, 79 back to normal this AM.

2021-02-18

Systemic reaction (other): I mainly feel foggy brained and as though I am wading neck deep in molasses

2021-02-19

Systemic reaction (other): Foggy brain, weary

2021-02-21

Systemic reaction (other): Just feeling off, not sick not well. Just blah

Release 5 — day 21, dose 2

2021-03-08

Symptoms: Joint aches, fatigue

Release 11 — 12 months, dose 2

2022-02-15

Symptoms: Unusual weight loss

Release 11 — day 0, dose 4

2022-05-02

Systemic reaction (other): Aches, pains & fatigue are chronic NOT RELATED TO THE Vaccine

Release 12 — day 42, dose 4

2022-06-13

Symptoms: Leg swelling, fluid retention

Release 12 — day 28, dose 5

2022-11-17

Symptoms: A very bad cold. Covid test negative

Release 12 — day 35, dose 5

2022-11-24

Symptoms: RSV. Acute respiratory failure with hypoxia. Admitted to (b)(6) Hospital 11/18 - 11/20

redacted (b)(6)

Release 12 — day 42, dose 5

2022-12-01

Symptoms: Hypoxia, nonproductive cough, fatigue

Healthcare visit (other): Office visit with PCP

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	Office visit	·	·	✓
SD	Acute respiratory failure	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Cough	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Fluid retention	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Hypoxia	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Respiratory syncytial virus infection	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Weight decreased	·	·	✓
SRO	Blood pressure increased	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Pre-existing disease	·	·	✓

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