3TW-30055-24792

2 vaccinations 6 coded responses 25 check-ins 6 free-text entries 3 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 920 / CA
Registered: 2021-01-29

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

2021-01-29
Registered in v-safe
2021-01-29
Dose 1 — Pfizer-BioNTech
2021-01-29
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-19
Dose 2 — Pfizer-BioNTech
2021-02-19
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good · Site: Pain

Free text: Literally just received vaccine dose 15 minutes ago.

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 · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, 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
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 35, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: It is odd, but over the last few days I have had a small point specific pain periodically occurring exactly where i received the second injection. No big deal, but makes stop and wonder what I did with or to my left shoulder, then I remember the vac

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 42, dose 2
MedDRA: Asthma, Upper respiratory tract infection — Feeling: Poor · 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: Upper respiratory infection leading to asthma symptoms. On antibiotics, prednisone and steroid inhaler which also includes a long acting bronchodialator.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-21
Survey response — 3 months, dose 2
MedDRA: Pre-existing disease, Upper respiratory tract infection — Feeling: Good · 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: Upper respiratory infection that also caused asthma related issues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-15
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-15
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-08-23
Survey response — 6 months, dose 2
MedDRA: Influenza virus test negative, Malaise, Nausea, Pain, Pyrexia, Respiratory disorder, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school

Free text: Upper and lower respiratory illness with low grade fever, malaise, aches and nausea. 14 days antibiotics. Still on inhalers. Covid-19 and influenza virus tests all negative.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-19
Survey response — 12 months, dose 2
MedDRA: Asthma, Pre-existing disease, Sinusitis, Upper respiratory tract infection — Feeling: Good · 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: Upper respiratory infection, sinusitis requiring antibiotics beginning of January. Long recovery due to history of and asthma symptoms. Recently finished taper off inhaled steroids.

MedDRA releases: 2024-11 · check-in free text available
2022-02-19
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-23
Call 1 — Left Voicemail
2022-02-23
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Pfizer-BioNTech
2	2021-02-19	Pfizer-BioNTech

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 4 — day 0, dose 2

2021-02-19

Systemic reaction (other): Literally just received vaccine dose 15 minutes ago.

Release 6 — day 35, dose 2

2021-03-26

Symptoms: It is odd, but over the last few days I have had a small point specific pain periodically occurring exactly where i received the second injection. No big deal, but makes stop and wonder what I did with or to my left shoulder, then I remember the vac cut off by CDC

Release 6 — day 42, dose 2

2021-04-02

Symptoms: Upper respiratory infection leading to asthma symptoms. On antibiotics, prednisone and steroid inhaler which also includes a long acting bronchodialator.

Release 8 — 3 months, dose 2

2021-05-21

Symptoms: Upper respiratory infection that also caused asthma related issues.

Release 9 — 6 months, dose 2

2021-08-23

Symptoms: Upper and lower respiratory illness with low grade fever, malaise, aches and nausea. 14 days antibiotics. Still on inhalers. Covid-19 and influenza virus tests all negative.

Release 11 — 12 months, dose 2

2022-02-19

Symptoms: Upper respiratory infection, sinusitis requiring antibiotics beginning of January. Long recovery due to history of and asthma symptoms. Recently finished taper off inhaled steroids.

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	Influenza virus test negative	✓	·	✓
SD	Injection site pain	✓	✓	✓
SD	Malaise	✓	·	✓
SD	Nausea	✓	·	✓
SD	Pain	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	·	✓
SD	Respiratory disorder	✓	·	✓
SD	SARS-CoV-2 test negative	✓	·	✓
SD	Sinusitis	·	·	✓
SD	Upper respiratory tract infection	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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