4G2-75988-99781

5 vaccinations 15 coded responses 33 check-ins 15 free-text entries 5 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 028 / RI
Registered: 2021-03-28

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

P2N-16367-36643 Child or adolescent in my care · Female · 2021-10-19

R65-19177-97719 Child or adolescent in my care · Male · 2021-10-19

MBW-13319-33061 Adult relative or friend · Female · 2021-10-19

UYX-17159-88570 Adult relative or friend · Female · 2021-10-19

Timeline

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

2021-03-28
Registered in v-safe
2021-03-28
Dose 1 — Pfizer-BioNTech
2021-03-28
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-03-30
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Feeling cold, Muscle tightness, Somnolence, Tension headache — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Head feels very tight, outer neck as well. Balance off. Body feels fabulous. Fatigued in middle of day. Fell asleep at 1:30 pm for an hour which I have never taken such an early nap in my life; except early as an infant. Felt cold but no fever. Was 97.9F. Fell asleep immediately after taking temp.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Fatigue, Rhinorrhoea, Somnolence — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sniffles; slept late, awoke very groggy; not very energetic today, kind of dragging.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Survey response — day 14, dose 1
MedDRA: Fatigue, Musculoskeletal discomfort — Feeling: Fair · Be unable to do your normal daily activities

Free text: Occasional twinges in the neck on the right side. Fatigue lingering.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Dose 2 — Pfizer-BioNTech
2021-04-18
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Neck pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Base of neck on back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Back pain, Cough, Myalgia, Neck pain, Rhinorrhoea — Feeling: Fair · Site: Pain · Muscle or body aches, Diarrhea

Free text: Sniffles, cough, knotted muscular pain in back of neck and upper shoulder

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Rhinorrhoea — Feeling: Good · Muscle or body aches

Free text: Sniffles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-05-02
Survey response — day 14, dose 2
MedDRA: Abdominal pain upper, Arthralgia, Balance disorder, Diarrhoea, Fatigue, Neck pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea, head aches, stomach ache, neck and shoulder pain, exhaustion, balance off.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Survey response — day 21, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: GI system

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Survey response — day 28, dose 2
MedDRA: Cough, Hypertension, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Dry cough, intermittent high blood pressure. · Healthcare visit (other): In person Dr appointment setup

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-19
Survey response — 6 months, dose 2
MedDRA: Hepatitis — 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: Liver inflamed

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Report sent to call center — 6 months, dose 2
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)
2021-10-21
Call 1 — Left Voicemail
2021-10-23
Dose 3 — Pfizer-BioNTech
2021-10-27
Call 2 — Left Voicemail
2021-12-04
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-22
Survey response — 3 months, dose 3
MedDRA: Sinusitis — 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 · Outpatient clinic or urgent care clinic visit

Free text: Sinus infection in December. Augmentin resolved.

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Report sent to call center — 3 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)
2022-01-24
Call 1 — Left Voicemail
2022-04-23
Survey response — 6 months, dose 3
MedDRA: Cough, Diarrhoea, Ear pain, Fatigue, Laboratory test abnormal, Office visit, Oropharyngeal pain, Pneumonia, Polymerase chain reaction positive, Sinus pain, Throat irritation — 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 · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Scratchy throat 3/28/22, tested pos 3/31 rapid, neg PCR. left side sore throat, left ear pain, forehead sinus pain. Contact at work five min & > 6 ft. 6 people +. 4/4 101.3 4/5 diarrhea, fatigue; 4/7 -4/10 cough, lungs infected. Well 4/16. Tired Now. · Healthcare visit (other): 3/31 urgent care; 4/14 Dr cleared

MedDRA releases: 2024-11 · check-in free text available
2022-04-23
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)
2022-04-25
Call 1 — Left Voicemail
2022-04-25
Call successful
Does not wish to fill out VAERS report
2022-05-14
Dose 4 — Pfizer-BioNTech
2022-09-09
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-09-20
Health check-in — day 7, dose 5
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-09-23
Survey response — day 14, dose 5
MedDRA: Oropharyngeal pain, Productive cough — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat, some phlegm

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Survey response — day 21, dose 5
MedDRA: Burning sensation, Ear pain, Lymphadenopathy, Sinus congestion, Sinusitis, Throat irritation — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Swollen glands in neck, both sides. Sinuses swollen in back - sinus infection. Left ear slight pain. Burn in back of sinus area. Slightly scratchy throat.

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Report sent to call center — day 21, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-06
Call 1 — Left Voicemail
2022-10-09
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-16
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-12-09
Survey response — 3 months, dose 5
MedDRA: Sinusitis — Feeling: Good

Free text: Sinus infected

MedDRA releases: 2024-11 · check-in free text available
2023-03-10
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-28	Pfizer-BioNTech
2	2021-04-18	Pfizer-BioNTech
3	2021-10-23	Pfizer-BioNTech	No
4	2022-05-14	Pfizer-BioNTech	No
5	2022-09-09	Pfizer-BioNTech	Flu

Call center

5 call center cases

3 successful · 2 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-30

Systemic reaction (other): Head feels very tight, outer neck as well. Balance off. Body feels fabulous. Fatigued in middle of day. Fell asleep at 1:30 pm for an hour which I have never taken such an early nap in my life; except early as an infant. Felt cold but no fever. Was 97.9F. Fell asleep immediately after taking temp.

2021-03-31

Systemic reaction (other): Sniffles; slept late, awoke very groggy; not very energetic today, kind of dragging.

Release 7 — day 14, dose 1

2021-04-11

Symptoms: Occasional twinges in the neck on the right side. Fatigue lingering.

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Base of neck on back pain

2021-04-23

Systemic reaction (other): Sniffles, cough, knotted muscular pain in back of neck and upper shoulder

2021-04-24

Systemic reaction (other): Sniffles

Release 8 — day 14, dose 2

2021-05-02

Symptoms: Diarrhea, head aches, stomach ache, neck and shoulder pain, exhaustion, balance off.

Release 8 — day 21, dose 2

2021-05-10

Symptoms: GI system

Release 8 — day 28, dose 2

2021-05-16

Symptoms: Dry cough, intermittent high blood pressure.

Healthcare visit (other): In person Dr appointment setup

Release 10 — 6 months, dose 2

2021-10-19

Symptoms: Liver inflamed

Release 11 — 3 months, dose 3

2022-01-22

Symptoms: Sinus infection in December. Augmentin resolved.

Release 11 — 6 months, dose 3

2022-04-23

Symptoms: Scratchy throat 3/28/22, tested pos 3/31 rapid, neg PCR. left side sore throat, left ear pain, forehead sinus pain. Contact at work five min & > 6 ft. 6 people +. 4/4 101.3 4/5 diarrhea, fatigue; 4/7 -4/10 cough, lungs infected. Well 4/16. Tired Now. cut off by CDC

Healthcare visit (other): 3/31 urgent care; 4/14 Dr cleared

Release 12 — day 14, dose 5

2022-09-23

Symptoms: Sore throat, some phlegm

Release 12 — day 21, dose 5

2022-09-30

Symptoms: Swollen glands in neck, both sides. Sinuses swollen in back - sinus infection. Left ear slight pain. Burn in back of sinus area. Slightly scratchy throat.

Release 12 — 3 months, dose 5

2022-12-09

Symptoms: Sinus infected

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	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Balance disorder	✓	✓	✓
SD	Burning sensation	·	·	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Ear pain	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Hepatitis	·	·	✓
SD	Hypertension	✓	✓	✓
SD	Laboratory test abnormal	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Musculoskeletal discomfort	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pneumonia	·	·	✓
SD	Polymerase chain reaction positive	·	·	✓
SD	Productive cough	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Sinus pain	·	·	✓
SD	Sinusitis	·	·	✓
SD	Throat irritation	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Muscle tightness	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Tension headache	✓	✓	✓

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