3TV-10115-92482

4 vaccinations 13 coded responses 26 check-ins 13 free-text entries 2 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 941 / CA
Registered: 2021-03-17

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-16
Dose 1 — Pfizer-BioNTech
2021-03-17
Registered in v-safe
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Hyperhidrosis — Feeling: Good · Fever

Free text: Light sweating overnight left my pillow slightly damp, indicative of a low fever; No fever symptoms today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Frequent bowel movements — Feeling: Good

Free text: Increased urgency of defecating- running to toilet several times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Fever · Chills, Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-06
Dose 2 — Pfizer-BioNTech
2021-04-06
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Bedridden, Chest pain, Dyspnoea, Flatulence, Food intolerance, Micturition urgency, Regurgitation — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: I've been bedridden for the past 4 days with multiple symptoms- in addition to those indicated shortness of breat, passing gas food intolerance, regurgitation, urinary urgency, right sided chest pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — day 7, dose 2
MedDRA: Ageusia, Anosmia, Decreased appetite, Dyspnoea, Sensory loss — Feeling: Fair · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: SHORTNESS F BREATH X 5 DAYS! ANOREXIA. LOSS OF SENSE OF SMELL& TASTE.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 14, dose 2
MedDRA: Ageusia, Bedridden, Chest pain, Chills, Cough, Decreased appetite, Diarrhoea, Dyspepsia, Dyspnoea, Fatigue, Food intolerance, Headache, Hiccups, Hyperhidrosis, Nausea, Pyrexia, Vomiting — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: 2 days after Pfizer vaccine #2, I had symptoms of fever/chills, sweating, nausea/vomiting, anorexia, loss of food taste/tolerance, hiccups, epigastric distress, right chest pain, loose stools, shortness of breath, bedridden 5 days; left with cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 28, dose 2
MedDRA: Cough, Nasal congestion — Feeling: Fair

Free text: Residual nasal congestion, occasional dry cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — day 35, dose 2
MedDRA: Back pain, Constipation, Impaired healing, Night sweats — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nights of pillow-drenching sweats, constipation, lumbosacral pain, poor wound healing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Survey response — day 42, dose 2
MedDRA: Fatigue, Hiccups, Nausea, Productive cough, Rash, Vomiting — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Had a bad bout of recurrent nausea, vomiting, hiccups, fatigue, productive cough- and a scant rash.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Survey response — 3 months, dose 2
MedDRA: Back pain, Constipation, Cough, Hyperhidrosis, Insomnia, Productive cough — Feeling: Fair

Free text: Well I have developed ongoing coughing up of phlegm and diaphoresis- worst siring nighttime slumber, as well as ongojng chronic constipation and chronic lower back pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-05
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-10-05
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-06
Survey response — 12 months, dose 2
MedDRA: Haematemesis, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Hadca nasty bout of hematemesis a month ago. · Healthcare visit (other): Picked up omeprazole

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-04-15
Dose 4 — Pfizer-BioNTech
2022-04-22
Health check-in — day 7, dose 4
Feeling: Good · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2022-04-29
Call 1 — Left Voicemail
2022-05-02
Survey response — day 14, dose 4
MedDRA: Condition aggravated, Constipation, Dehydration, Dyspnoea, Fatigue, Gastritis, Haematemesis, Hiatus hernia, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Flare up of esophagitis, gastritis, hiatal hernia with projectile hematemesis, resulting in dehydration, constipation and exacerbation of iron deficiency anemia, which is marked by extreme fatigue and shortness of breath.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-20
Survey response — day 35, dose 4
MedDRA: Vomiting projectile — Feeling: Fair · Be unable to do your normal daily activities

Free text: Recurrent projectile vomiting

MedDRA releases: 2024-11 · check-in free text available
2022-05-27
Survey response — day 42, dose 4
MedDRA: Haematemesis, Unevaluable event, Vomiting projectile — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Another 2 bouts of projectile vomiting- one with hematemesis. · Healthcare visit (other): Omeprazole- I'ce taken it nearly a year.

MedDRA releases: 2024-11 · check-in free text available
2022-05-27
Report sent to call center — day 42, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-06-01
Call 2 — Left Voicemail
2022-06-01
Call 1 — Left Voicemail
2022-07-17
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Pfizer-BioNTech
2	2021-04-06	Pfizer-BioNTech
3	2021-10-05	Pfizer-BioNTech	Flu
4	2022-04-15	Pfizer-BioNTech	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Light sweating overnight left my pillow slightly damp, indicative of a low fever; No fever symptoms today.

2021-03-18

Systemic reaction (other): Increased urgency of defecating- running to toilet several times

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): I've been bedridden for the past 4 days with multiple symptoms- in addition to those indicated shortness of breat, passing gas food intolerance, regurgitation, urinary urgency, right sided chest pain

Release 7 — day 7, dose 2

2021-04-13

Systemic reaction (other): SHORTNESS F BREATH X 5 DAYS! ANOREXIA. LOSS OF SENSE OF SMELL& TASTE.

Release 7 — day 14, dose 2

2021-04-22

Symptoms: 2 days after Pfizer vaccine #2, I had symptoms of fever/chills, sweating, nausea/vomiting, anorexia, loss of food taste/tolerance, hiccups, epigastric distress, right chest pain, loose stools, shortness of breath, bedridden 5 days; left with cough cut off by CDC

Release 8 — day 28, dose 2

2021-05-04

Symptoms: Residual nasal congestion, occasional dry cough.

Release 8 — day 35, dose 2

2021-05-11

Symptoms: Nights of pillow-drenching sweats, constipation, lumbosacral pain, poor wound healing.

Release 8 — day 42, dose 2

2021-05-20

Symptoms: Had a bad bout of recurrent nausea, vomiting, hiccups, fatigue, productive cough- and a scant rash.

Release 9 — 3 months, dose 2

2021-07-06

Symptoms: Well I have developed ongoing coughing up of phlegm and diaphoresis- worst siring nighttime slumber, as well as ongojng chronic constipation and chronic lower back pain.

Release 11 — 12 months, dose 2

2022-04-06

Symptoms: Hadca nasty bout of hematemesis a month ago.

Healthcare visit (other): Picked up omeprazole

Release 11 — day 14, dose 4

2022-05-02

Symptoms: Flare up of esophagitis, gastritis, hiatal hernia with projectile hematemesis, resulting in dehydration, constipation and exacerbation of iron deficiency anemia, which is marked by extreme fatigue and shortness of breath.

Release 11 — day 35, dose 4

2022-05-20

Symptoms: Recurrent projectile vomiting

Release 11 — day 42, dose 4

2022-05-27

Symptoms: Another 2 bouts of projectile vomiting- one with hematemesis.

Healthcare visit (other): Omeprazole- I'ce taken it nearly a year.

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	Unevaluable event	·	·	✓
SD	Ageusia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Bedridden	✓	✓	○
SD	Chest pain	✓	✓	✓
SD	Chills	✓	✓	○
SD	Condition aggravated	·	·	✓
SD	Constipation	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Dehydration	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspepsia	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Food intolerance	·	·	✓
SD	Gastritis	·	·	✓
SD	Haematemesis	·	·	✓
SD	Headache	✓	✓	○
SD	Hiatus hernia	·	·	✓
SD	Hiccups	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Impaired healing	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Night sweats	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Productive cough	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Vomiting	✓	✓	✓
SD	Vomiting projectile	·	·	✓
SRO	Ageusia	✓	✓	✓
SRO	Anosmia	✓	✓	✓
SRO	Bedridden	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Food intolerance	✓	✓	✓
SRO	Frequent bowel movements	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Micturition urgency	✓	✓	✓
SRO	Regurgitation	✓	✓	✓
SRO	Sensory loss	✓	✓	✓

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