4B5-18437-13680

4 vaccinations 18 coded responses 47 check-ins 18 free-text entries 7 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 921 / CA
Registered: 2021-05-19

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

2021-05-19
Registered in v-safe
2021-05-19
Dose 1 — Pfizer-BioNTech
2021-05-19
Survey response — day 0, dose 1
MedDRA: Adverse reaction — Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Free text: These are symptoms common for me. I am sure not related to vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: These are likely from preexisting conditions

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to work

Free text: These are common for me. Likely not from vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-05-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-05-26
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-06-02
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-06-09
Health check-in — day 21, dose 1
Feeling: Poor

Adult check-in
2021-06-10
Dose 2 — Pfizer-BioNTech
2021-06-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-06-17
Health check-in — day 7, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-06-24
Survey response — day 14, dose 2
MedDRA: Fatigue, Fungal infection, Headache, Infection, Lymphadenopathy, Nausea, Oropharyngeal pain, Pyrexia, Rash, Vomiting — 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: Rashes, infections, slight fever, headache, sore throat, cough. Diagnosed as fungal infections in armpits that caused swollen lymph nodes. Either that or antifungal seems to be causing the rest - also nausea, vomiting, and fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Report sent to call center — day 14, 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)
2021-06-30
Call 2 — Left Voicemail
2021-07-01
Survey response — day 21, dose 2
MedDRA: Ageusia — Feeling: Fair

Free text: Loss of taste

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-07-15
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-07-22
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-09
Survey response — 3 months, dose 2
MedDRA: Office visit, Tooth disorder, Tooth extraction — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Unrelated to vaccine. Tooth issue & extraction. · Healthcare visit (other): Dentist and Oral surgeon

MedDRA releases: 2024-11 · check-in free text available
2021-09-09
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-09
Health check-in — 6 months, dose 2
Feeling: Poor

Adult check-in
2021-12-20
Dose 3 — Moderna
Co-administered: Flu
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-12-22
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lack of appetite - moderate

MedDRA releases: 2024-11 · check-in free text available
2021-12-23
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Sore throat - mild

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-12-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-12-26
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Fatigue or tiredness

Free text: Sore throat mild

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Survey response — day 7, dose 3
MedDRA: Sneezing — Feeling: Poor · Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Sneezing

MedDRA releases: 2024-11 · check-in free text available
2022-01-03
Survey response — day 14, dose 3
MedDRA: Cough, Pre-existing disease, Sneezing — Feeling: Fair · Be unable to work or attend school

Free text: Cough, sneezing - very sure caused by allergies. No fever

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Survey response — day 21, dose 3
MedDRA: Cough, Fatigue, Nasal congestion, Pre-existing disease, Sneezing — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Cough, sneezing, nasal congestion, and fatigue - I think this is still allergies, but I am a tad more concerned

MedDRA releases: 2024-11 · check-in free text available
2022-01-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-31
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-21
Survey response — 3 months, dose 3
MedDRA: Unevaluable event — Feeling: Fair · 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: Potential heart arrhythmia

MedDRA releases: 2024-11 · check-in free text available
2022-03-21
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-23
Call 1 — Left Voicemail
2022-05-10
Dose 4 — Moderna
Co-administered: Shingles
2022-05-11
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-05-12
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-13
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-15
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Headache, Muscle or body aches

Adult check-in
2022-05-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-17
Survey response — day 7, dose 4
MedDRA: Pre-existing disease, Tremor — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tremors, but all of these often reoccur from preexisting conditions

MedDRA releases: 2024-11 · check-in free text available
2022-05-24
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-31
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-07
Survey response — day 28, dose 4
MedDRA: Pre-existing disease — 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 · Telehealth, virtual health, or email health consultation

Free text: Depression and anxiety, preexisting conditions

MedDRA releases: 2024-11 · check-in free text available
2022-06-07
Report sent to call center — day 28, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-08
Call 1 — Left Voicemail
2022-06-08
Call 1 — Left Voicemail
2022-06-08
Call 2 — Left Voicemail
2022-06-08
Call 1 — Left Voicemail
2022-06-14
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-21
Survey response — day 42, dose 4
MedDRA: Anxiety, Back pain, Depression, Pre-existing disease — 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 · Telehealth, virtual health, or email health consultation

Free text: Unrelated to vaccine. Preexisting depression and anxiety worsening & back pain

MedDRA releases: 2024-11 · check-in free text available
2022-06-21
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-22
Call 2 — Left Voicemail
2022-06-22
Call 3 — Left Voicemail
2022-06-22
Call 2 — Left Voicemail
2022-06-22
Call 1 — Left Voicemail
2022-08-10
Survey response — 3 months, dose 4
MedDRA: Back injury, Back pain, Physiotherapy, Pre-existing disease — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Back pain - pre-existing condition reinjured · Healthcare visit (other): Physical therapy

MedDRA releases: 2024-11 · check-in free text available
2022-08-10
Report sent to call center — 3 months, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-11
Call 3 — Left Voicemail
2022-08-11
Call 3 — Left Voicemail
2022-08-11
Call 3 — Left Voicemail
2022-08-11
Call 2 — Left Voicemail
2022-08-11
Call 1 — Left Voicemail
2022-11-08
Survey response — 6 months, dose 4
MedDRA: Balance disorder, Blood glucose abnormal, Chest discomfort, Fall, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Episodes of chest tightness, followed by lack of balance, wobbly, fallen once. Cause unknown, but likely blood sugar. · Healthcare visit (other): Office visit with primary care physician (next day)

MedDRA releases: 2024-11 · check-in free text available
2022-11-08
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-09
Call X — Left Voicemail
2022-11-09
Call X — Left Voicemail
2022-11-09
Call X — Left Voicemail
2022-11-09
Call 3 — Left Voicemail
2022-11-09
Call 2 — Left Voicemail
2022-11-09
Call 1 — Left Voicemail
2023-05-11
Health check-in — 12 months, dose 4
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-19	Pfizer-BioNTech
2	2021-06-10	Pfizer-BioNTech
3	2021-12-20	Moderna	Flu
4	2022-05-10	Moderna	Shingles

Call center

7 call center cases

1 successful · 6 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 8 — day 0, dose 1

2021-05-19

Systemic reaction (other): These are symptoms common for me. I am sure not related to vaccine.

Release 8 — days 1–6 daily, dose 1

2021-05-20

Systemic reaction (other): These are likely from preexisting conditions

2021-05-21

Systemic reaction (other): These are common for me. Likely not from vaccine

Release 9 — day 14, dose 2

2021-06-24

Symptoms: Rashes, infections, slight fever, headache, sore throat, cough. Diagnosed as fungal infections in armpits that caused swollen lymph nodes. Either that or antifungal seems to be causing the rest - also nausea, vomiting, and fatigue.

Release 9 — day 21, dose 2

2021-07-01

Symptoms: Loss of taste

Release 9 — 3 months, dose 2

2021-09-09

Symptoms: Unrelated to vaccine. Tooth issue & extraction.

Healthcare visit (other): Dentist and Oral surgeon

Release 10 — days 1–6 daily, dose 3

2021-12-22

Systemic reaction (other): Lack of appetite - moderate

2021-12-23

Systemic reaction (other): Sore throat - mild

2021-12-26

Systemic reaction (other): Sore throat mild

Release 10 — day 7, dose 3

2021-12-28

Systemic reaction (other): Sneezing

Release 10 — day 14, dose 3

2022-01-03

Symptoms: Cough, sneezing - very sure caused by allergies. No fever

Release 10 — day 21, dose 3

2022-01-10

Symptoms: Cough, sneezing, nasal congestion, and fatigue - I think this is still allergies, but I am a tad more concerned

Release 11 — 3 months, dose 3

2022-03-21

Symptoms: Potential heart arrhythmia

Release 11 — day 7, dose 4

2022-05-17

Systemic reaction (other): Tremors, but all of these often reoccur from preexisting conditions

Release 11 — day 28, dose 4

2022-06-07

Symptoms: Depression and anxiety, preexisting conditions

Release 12 — day 42, dose 4

2022-06-21

Symptoms: Unrelated to vaccine. Preexisting depression and anxiety worsening & back pain

Release 12 — 3 months, dose 4

2022-08-10

Symptoms: Back pain - pre-existing condition reinjured

Healthcare visit (other): Physical therapy

Release 12 — 6 months, dose 4

2022-11-08

Symptoms: Episodes of chest tightness, followed by lack of balance, wobbly, fallen once. Cause unknown, but likely blood sugar.

Healthcare visit (other): Office visit with primary care physician (next day)

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	Office visit	·	·	✓
HCVO	Physiotherapy	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Ageusia	✓	✓	✓
SD	Anxiety	·	·	✓
SD	Back injury	·	·	✓
SD	Back pain	·	·	✓
SD	Balance disorder	·	·	✓
SD	Blood glucose abnormal	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Cough	·	·	✓
SD	Depression	·	·	✓
SD	Fall	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Fungal infection	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Infection	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Sneezing	·	·	✓
SD	Tooth disorder	·	·	✓
SD	Tooth extraction	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Vomiting	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Decreased appetite	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sneezing	·	·	✓
SRO	Tremor	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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