4TF-30712-90156

3 vaccinations 6 coded responses 25 check-ins 6 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 952 / CA
Registered: 2021-01-12

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-12
Registered in v-safe
2021-01-12
Dose 1 — Pfizer-BioNTech
2021-01-12
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair

Free text: I thought I may have had a little difficulty in breathing during a 40 minute walk this morning but it didn't last

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: I don't think this has anything to do with vaccin like vertigone but I've developed a mild dizziness like

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Survey response — day 7, dose 1
MedDRA: Dizziness, Vertigo — Feeling: Fair

Free text: Still dealing with a bit dizziness or vertigo.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-02
Dose 2 — Pfizer-BioNTech
2021-02-02
Health check-in — day 0, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-02
Survey response — day 28, dose 2
MedDRA: Musculoskeletal chest pain — Feeling: Fair

Free text: I've developed a pain on my left side just below ribs. Don't know if it's related to vaccine? Otherwise I'm ok.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Today very tired, had a tough time completing my daily 2 mile walk however I feel fine if at rest and relaxed!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-03
Survey response — 6 months, dose 2
MedDRA: Cardiac pacemaker insertion, Cardiac pacemaker removal, Hypersensitivity, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Had a failed pacemaker removed & new one implanted in May on the 7th, stll recuperating. Otherwise my sinus' allergies still bothering me.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-03
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

1 call case(s)
2021-08-14
Call 1 — Left Voicemail
2021-11-05
Dose 3 — Pfizer-BioNTech
2022-02-03
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-05
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Pfizer-BioNTech
2	2021-02-02	Pfizer-BioNTech
3	2021-11-05	Pfizer-BioNTech	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): I thought I may have had a little difficulty in breathing during a 40 minute walk this morning but it didn't last

2021-01-18

Systemic reaction (other): I don't think this has anything to do with vaccin like vertigone but I've developed a mild dizziness like

Release 2 — day 7, dose 1

2021-01-19

Systemic reaction (other): Still dealing with a bit dizziness or vertigo.

Release 4 — day 28, dose 2

2021-03-02

Symptoms: I've developed a pain on my left side just below ribs. Don't know if it's related to vaccine? Otherwise I'm ok.

Release 5 — day 35, dose 2

2021-03-09

Symptoms: Today very tired, had a tough time completing my daily 2 mile walk however I feel fine if at rest and relaxed!

Release 9 — 6 months, dose 2

2021-08-03

Symptoms: Had a failed pacemaker removed & new one implanted in May on the 7th, stll recuperating. Otherwise my sinus' allergies still bothering me.

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	Cardiac pacemaker insertion	✓	·	✓
SD	Cardiac pacemaker removal	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Hypersensitivity	✓	·	✓
SD	Musculoskeletal chest pain	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Vertigo	✓	✓	✓

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