3WN-45825-95089

3 vaccinations 9 coded responses 20 check-ins 9 free-text entries 3 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 189 / PA
Registered: 2021-03-13

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

2021-03-13
Registered in v-safe
2021-03-13
Dose 1 — Pfizer-BioNTech
2021-03-13
Health check-in — day 0, dose 1
Feeling: Good · None · Be unable to work

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-03-20
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-27
Survey response — day 14, dose 1
MedDRA: Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: I keep feeling like I am going to throw up! Not constant nausea, but that feeling just fine moment before you heave.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — day 21, dose 1
MedDRA: Feeling abnormal — Feeling: Poor · Be unable to do your normal daily activities

Free text: I get a weird feeling like Im just about to vomit, not normal nausea. Just the feeling right before you heave your guts up!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Dose 2 — Pfizer-BioNTech
2021-04-17
Survey response — day 7, dose 2
MedDRA: Failed back surgery syndrome, Pain, Pre-existing disease — Feeling: Good · Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Had Failed Spinal Surgery 1* Chronic Intractable Pain since 10/2008 · Healthcare visit (other): All R/T pre-existing conditions, and the forced reduction in my Pain Medications!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Report sent to call center — day 7, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-05
Survey response — 3 months, dose 2
MedDRA: Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: I may have reported this last time, but one day in April \May, I had the feeling just before you vomit, but without nausea, and only vomited once. Doubt its related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-19
Dose 3 — Other-Unknown
2021-10-04
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: After my booster shot (CVS) my shoulder hurt for a week, and I felt run down.

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Survey response — day 42, dose 3
MedDRA: Arthralgia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: After 3rd Covid-19 vaccination from CVS ([phone]) my shoulder hurt for a week, and I felt run-down. I had to go back to the store Nxt day to get Vac Record card, which was matter-of-factily written without checking records, says Pfizer (no lot#)

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Survey response — 3 months, dose 3
MedDRA: Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: Spontaneously vomiting, without s/s (nausea, bad eat, illness, etc.). After puking a few times I'm fine.

MedDRA releases: 2024-11 · check-in free text available
2022-02-17
Survey response — 6 months, dose 3
MedDRA: Fatigue, Night sweats, Unevaluable event, Vomiting, Weight decreased — 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 · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Fatigue, 60lbs unplanned weight loss, vomiting spontaneously, night sweats · Healthcare visit (other): Ct scan, Gastric emptying study, mrii

MedDRA releases: 2024-11 · check-in free text available
2022-02-17
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-18
Call 1 — Left Voicemail
2022-08-19
Survey response — 12 months, dose 3
MedDRA: Abnormal loss of weight, Impaired gastric emptying, Large intestinal ulcer, Unevaluable event — 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, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Gastroparesis, ulcer in colon, 50-60lbs weight loss- unintentional. · Healthcare visit (other): Endoscopy center

MedDRA releases: 2024-11 · check-in free text available
2022-08-19
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-22
Call 1 — Left Voicemail
2022-08-22
Call 2 — Left Voicemail
2022-08-22
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Pfizer-BioNTech
2	2021-04-05	Pfizer-BioNTech
3	2021-08-19	Other-Unknown	No

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 6 — day 14, dose 1

2021-03-27

Symptoms: I keep feeling like I am going to throw up! Not constant nausea, but that feeling just fine moment before you heave.

Release 6 — day 21, dose 1

2021-04-03

Symptoms: I get a weird feeling like Im just about to vomit, not normal nausea. Just the feeling right before you heave your guts up!

Release 7 — day 7, dose 2

2021-04-17

Systemic reaction (other): Had Failed Spinal Surgery 1* Chronic Intractable Pain since 10/2008

Healthcare visit (other): All R/T pre-existing conditions, and the forced reduction in my Pain Medications!

Release 9 — 3 months, dose 2

2021-07-05

Symptoms: I may have reported this last time, but one day in April \May, I had the feeling just before you vomit, but without nausea, and only vomited once. Doubt its related.

Release 10 — day 42, dose 3

2021-10-04

Symptoms: After 3rd Covid-19 vaccination from CVS ([phone]) my shoulder hurt for a week, and I felt run-down. I had to go back to the store Nxt day to get Vac Record card, which was matter-of-factily written without checking records, says Pfizer (no lot#)

Release 10 — 6 months, dose 2

2021-10-04

Symptoms: After my booster shot (CVS) my shoulder hurt for a week, and I felt run down.

Release 10 — 3 months, dose 3

2021-11-18

Symptoms: Spontaneously vomiting, without s/s (nausea, bad eat, illness, etc.). After puking a few times I'm fine.

Release 11 — 6 months, dose 3

2022-02-17

Symptoms: Fatigue, 60lbs unplanned weight loss, vomiting spontaneously, night sweats

Healthcare visit (other): Ct scan, Gastric emptying study, mrii

Release 12 — 12 months, dose 3

2022-08-19

Symptoms: Gastroparesis, ulcer in colon, 50-60lbs weight loss- unintentional.

Healthcare visit (other): Endoscopy center

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	Pain	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Abnormal loss of weight	·	·	✓
SD	Arthralgia	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling abnormal	✓	✓	✓
SD	Impaired gastric emptying	·	·	✓
SD	Large intestinal ulcer	·	·	✓
SD	Nausea	✓	✓	✓
SD	Night sweats	·	·	✓
SD	Vomiting	✓	✓	✓
SD	Weight decreased	·	·	✓
SRO	Failed back surgery syndrome	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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