3SE-49091-11969

5 vaccinations 7 coded responses 55 check-ins 6 free-text entries 2 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 840 / UT
Registered: 2021-01-12

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

Timeline

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

2021-01-12
Registered in v-safe
2021-01-12
Dose 1 — Pfizer-BioNTech
2021-01-12
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-02
Dose 2 — Pfizer-BioNTech
2021-02-02
Survey response — day 0, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Shore throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · 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
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — day 14, dose 2
MedDRA: Bronchiectasis, Condition aggravated, Pain, Pre-existing disease, Pyrexia — Feeling: Fair

Free text: Aches and discomfort; Fatigue; Lungs -Exacerbation of Bronchiectasis without any other apparent, plausible explanation; slight fever (could relate to the prior). Just not sure, so thought i would share.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-27
Dose 3 — Moderna
2021-10-27
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, 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: Good · Site: Pain · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-03
Health check-in — day 7, dose 3
Feeling: Poor · Site: Pain · Headache · Be unable to work or attend school

Adult check-in
2021-11-10
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-26
Survey response — 3 months, dose 3
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Fair

Free text: I have a cold. Covid test after 2 days from onset indicated negative results.

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-11
Dose 4 — Pfizer-BioNTech
2022-05-15
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-18
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-25
Survey response — day 14, dose 4
MedDRA: Nasopharyngitis, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I caught a cold, but fir me and my lung disease that gets pretty intense.

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-10
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-20
Dose 5 — Moderna
Co-administered: Flu
2022-09-25
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-27
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-06
Health check-in — day 14, dose 5
Feeling: Good

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

Adult check-in
2022-10-18
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-25
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-01
Survey response — day 42, dose 5
MedDRA: Nasopharyngitis, Sinus disorder — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: A cold with sinus issues.

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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-02
Call successful
Not applicable - Accidental Reporting
2022-12-22
Survey response — 3 months, dose 5
MedDRA: Asthma — Feeling: Good

Free text: Asthma still afn issue. Cold air, inversion, exertion, etc. Working to manage it.

MedDRA releases: 2024-11 · check-in free text available
2023-03-21
Survey response — 6 months, dose 5
MedDRA: Nasopharyngitis — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-21
Report sent to call center — 6 months, dose 5
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Pfizer-BioNTech
2	2021-02-02	Pfizer-BioNTech
3	2021-10-27	Moderna	No
4	2022-05-11	Pfizer-BioNTech	No
5	2022-09-20	Moderna	Flu

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 3 — day 0, dose 2

2021-02-02

Systemic reaction (other): Shore throat.

Release 4 — day 14, dose 2

2021-02-18

Symptoms: Aches and discomfort; Fatigue; Lungs -Exacerbation of Bronchiectasis without any other apparent, plausible explanation; slight fever (could relate to the prior). Just not sure, so thought i would share.

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: I have a cold. Covid test after 2 days from onset indicated negative results.

Release 11 — day 14, dose 4

2022-05-25

Symptoms: I caught a cold, but fir me and my lung disease that gets pretty intense.

Release 12 — day 42, dose 5

2022-11-01

Symptoms: A cold with sinus issues.

Release 12 — 3 months, dose 5

2022-12-22

Symptoms: Asthma still afn issue. Cold air, inversion, exertion, etc. Working to manage it.

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	Asthma	·	·	✓
SD	Bronchiectasis	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus disorder	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓

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