3TN-15414-10607

4 vaccinations 10 coded responses 44 check-ins 10 free-text entries 0 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 850 / AZ
Registered: 2021-01-19

Relationship: Self
Race: White
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

2021-01-18
Dose 1 — Pfizer-BioNTech
2021-01-19
Registered in v-safe
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: Blepharospasm, Pain in jaw, Tenderness — Feeling: Good

Free text: Right eye twitching most of the last three days. Experienced jaw pain for two days but that seems to be gone now... only sore to the touch.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Blepharospasm — Feeling: Good

Free text: Continuing problem with right eye twitching incessantly. It doesnt hurt but is quite annoying

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Blepharospasm — Feeling: Good · Fatigue or tiredness

Free text: My right eye is still twitching. It is relatively constant all day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Blepharospasm — Feeling: Good

Free text: I still have a bit of twitching in my right eye

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — day 7, dose 1
MedDRA: Blepharospasm — Feeling: Good

Free text: My eye still continues to twitch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-08
Dose 2 — Pfizer-BioNTech
2021-02-08
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Survey response — day 14, dose 2
MedDRA: Trismus — Feeling: Good

Free text: Some lock jaw for 36 hours on 2/17-2/18

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-16
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-09-29
Survey response — day 7, dose 3
MedDRA: Cough, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I had considerable congestion and coughing fir ten days post third shot with multiple negative covid tests. I received the flu shot at the same time as this third shot as well. My cough has lingered through today (day 13) but it is very minimal.

MedDRA releases: 2024-11 · check-in free text available
2021-09-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-07
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-14
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-21
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-28
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-16
Survey response — 3 months, dose 3
MedDRA: Cough, Sinus congestion — Feeling: Fair

Free text: General sinus congestion and cough.

MedDRA releases: 2024-11 · check-in free text available
2022-03-17
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-17
Dose 4 — Moderna
2022-05-18
Survey response — days 1–6 daily, dose 4
MedDRA: Cough — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I've had a slight cough develop over the day

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, 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
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2022-05-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness, Diarrhea

Adult check-in
2022-05-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Diarrhea

Adult check-in
2022-05-24
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-31
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-07
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-14
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-21
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-28
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-16
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-17
Survey response — 6 months, dose 4
MedDRA: Cough, Productive cough, Respiratory tract congestion — Feeling: Good

Free text: Congestion Cough Phlegm

MedDRA releases: 2024-11 · check-in free text available
2023-05-17
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-18	Pfizer-BioNTech
2	2021-02-08	Pfizer-BioNTech
3	2021-09-16	Pfizer-BioNTech	Flu
4	2022-05-17	Moderna	No

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-21

Systemic reaction (other): Right eye twitching most of the last three days. Experienced jaw pain for two days but that seems to be gone now... only sore to the touch.

2021-01-22

Systemic reaction (other): Continuing problem with right eye twitching incessantly. It doesnt hurt but is quite annoying

2021-01-23

Systemic reaction (other): My right eye is still twitching. It is relatively constant all day.

2021-01-24

Systemic reaction (other): I still have a bit of twitching in my right eye

Release 2 — day 7, dose 1

2021-01-25

Systemic reaction (other): My eye still continues to twitch

Release 4 — day 14, dose 2

2021-02-22

Symptoms: Some lock jaw for 36 hours on 2/17-2/18

Release 9 — day 7, dose 3

2021-09-29

Systemic reaction (other): I had considerable congestion and coughing fir ten days post third shot with multiple negative covid tests. I received the flu shot at the same time as this third shot as well. My cough has lingered through today (day 13) but it is very minimal.

Release 10 — 3 months, dose 3

2021-12-16

Symptoms: General sinus congestion and cough.

Release 11 — days 1–6 daily, dose 4

2022-05-18

Systemic reaction (other): I've had a slight cough develop over the day

Release 12 — 6 months, dose 4

2022-11-17

Symptoms: Congestion Cough Phlegm

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	Cough	·	·	✓
SD	Productive cough	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Trismus	✓	✓	✓
SRO	Blepharospasm	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	SARS-CoV-2 test negative	·	·	✓
SRO	Tenderness	✓	✓	✓

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