47V-96050-31725
5 vaccinations
3 coded responses
64 check-ins
3 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 604 / IL
- Registered
- 2021-03-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
3NQ-17206-85508
Child or adolescent in my care · Female · 2022-06-21
Timeline
-
2021-03-27
Registered in v-safe
-
2021-03-27
Dose 1 — Pfizer-BioNTech
- 2021-03-27
-
2021-03-28
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-03-29
- 2021-03-30
-
2021-03-31
Health check-in — days 1–6 daily, dose 1Feeling: Good · Muscle or body aches, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-10
-
2021-04-17
Dose 2 — Pfizer-BioNTech
- 2021-04-17
-
2021-04-18
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-24
- 2021-05-01
- 2021-05-08
-
2021-05-15
Survey response — day 28, dose 2MedDRA: Condition aggravated, Office visit, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Significant worsening of Raynaud's phenomenon (secondary, with onset in last 6 mo). Visited rheumatologist this past week for further assessment and testing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-15
Report sent to call center — day 28, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-22
- 2021-05-29
- 2021-07-17
-
2021-10-12
Dose 3 — Pfizer-BioNTech
- 2021-10-12
-
2021-10-13
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, DiarrheaAdult check-in
-
2021-10-14
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-10-15
- 2021-10-16
- 2021-10-17
-
2021-10-18
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-19
- 2021-10-26
-
2021-11-02
Survey response — day 21, dose 3MedDRA: Back pain, Pain, Painful respiration, Tenderness — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Fairly severe back pain, left of spine, radiating up and down from area between shoulder blade and spine. Tender. Deep breaths hurt. Assumed to be unrelated and possibly a thoracic disk issue. Have not gone to doctor, but reporting for completeness.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-09
- 2021-11-23
- 2022-01-13
- 2022-04-12
- 2022-04-18
-
2022-06-28
Dose 4 — Moderna
- 2022-06-29
- 2022-06-30
-
2022-07-01
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection siteAdult check-in
- 2022-07-02
- 2022-07-04
- 2022-07-05
- 2022-07-12
-
2022-07-19
Survey response — day 21, dose 4MedDRA: Diverticulitis, Hereditary disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: (NOTE- GI symptoms reported for family member are for me only. Accidentally entered for her. She has no symptoms). GI symptoms, diverticulitis suspected based on symptoms and family history. Reaching out to doc today.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-19
Report sent to call center — day 21, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-07-20
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-07-26
- 2022-08-02
- 2022-08-10
- 2022-09-27
-
2022-10-06
Dose 5 — Moderna
-
2022-10-06
Health check-in — day 0, dose 5Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea, Abdominal painAdult check-in
-
2022-10-07
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea, Abdominal painAdult check-in
-
2022-10-08
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-10-09
- 2022-10-10
- 2022-10-11
- 2022-10-12
- 2022-10-15
- 2022-10-20
- 2022-10-27
- 2022-11-03
- 2022-11-10
- 2022-11-17
- 2023-01-05
- 2023-04-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-27 | Pfizer-BioNTech | |
| 2 | 2021-04-17 | Pfizer-BioNTech | |
| 3 | 2021-10-12 | Pfizer-BioNTech | No |
| 4 | 2022-06-28 | Moderna | No |
| 5 | 2022-10-06 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 8 — day 28, dose 2
Symptoms: Significant worsening of Raynaud's phenomenon (secondary, with onset in last 6 mo). Visited rheumatologist this past week for further assessment and testing.
Release 10 — day 21, dose 3
Symptoms: Fairly severe back pain, left of spine, radiating up and down from area between shoulder blade and spine. Tender. Deep breaths hurt. Assumed to be unrelated and possibly a thoracic disk issue. Have not gone to doctor, but reporting for completeness. cut off by CDC
Release 12 — day 21, dose 4
Symptoms: (NOTE- GI symptoms reported for family member are for me only. Accidentally entered for her. She has no symptoms). GI symptoms, diverticulitis suspected based on symptoms and family history. Reaching out to doc today.
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 | Back pain | · | · | ✓ |
| SD | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Diverticulitis | · | · | ✓ |
| SD | Hereditary disorder | · | · | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Painful respiration | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Tenderness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release