4U4-26446-26633

3 vaccinations 10 coded responses 26 check-ins 10 free-text entries 1 call case

Sex: Male
Age at first dose: 36-40
ZIP prefix: 472 / IN
Registered: 2021-02-11

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

Timeline

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

2021-02-11
Registered in v-safe
2021-02-11
Dose 1 — Pfizer-BioNTech
2021-02-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Good · Headache

Free text: Seems the vaccine is having difficulty crossing the blood brain barrier causing the headache. Just an observation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Ear swelling, Headache — Feeling: Fair · Headache

Free text: Swelling above and behind right ear. Headache moved to the ear. Thankfully I use accupressure and furrowed away the inflammation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal disorder, Self-medication — Feeling: Good

Free text: Blew a suture out my nose today. That's been in there a while. Thanks for the vaccine and Advil CF.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-08
Dose 2 — Pfizer-BioNTech
2021-03-08
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain upper — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Free text: Stomach Cramp at Diaphragm after vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Swelling — Feeling: Good

Free text: Had an itch swelled up three inches away from where it itched. Went away after an hour.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Sluggishness — Feeling: Good · Fever · Fatigue or tiredness · Be unable to work

Free text: Sluggish & Tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-22
Survey response — day 14, dose 2
MedDRA: Abdominal pain upper, Chills, Epistaxis, Increased appetite, Myalgia, Pyrexia, Weight increased — Feeling: Good

Free text: Weight Gain, Increased Appetite this week like with steroids and a Bloody Nose Yesterday. Stomach Churns too. Idk? No fever chills or muscle aches to report. Breathing Great.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-05
Survey response — day 28, dose 2
MedDRA: Fatigue, Sneezing, Somnolence — Feeling: Fair

Free text: Marked Drowsiness and Fatigue today.Sneezing yesterday think it's allergies.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-08
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-13
Dose 3 — Pfizer-BioNTech
2021-09-06
Survey response — 6 months, dose 2
MedDRA: Eye pain, Pre-existing disease — Feeling: Good · Be unable to work or attend school

Free text: Eye Aches, could be seasonal allergies. Definitely painful.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-12
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-02-11
Survey response — 6 months, dose 3
MedDRA: Cystic lung disease, Inguinal hernia, Thrombosis, Unevaluable event — 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: Symptoms: Had a bleb rupture in my lung. Sent a blood clot to the rectum. Where it herniated. Not a good week. · Healthcare visit (other): Referral

MedDRA releases: 2024-11 · check-in free text available
2022-02-11
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-16
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Pfizer-BioNTech
2	2021-03-08	Pfizer-BioNTech
3	2021-08-13	Pfizer-BioNTech	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-13

Systemic reaction (other): Seems the vaccine is having difficulty crossing the blood brain barrier causing the headache. Just an observation.

2021-02-14

Systemic reaction (other): Swelling above and behind right ear. Headache moved to the ear. Thankfully I use accupressure and furrowed away the inflammation.

2021-02-16

Systemic reaction (other): Blew a suture out my nose today. That's been in there a while. Thanks for the vaccine and Advil CF.

Release 5 — days 1–6 daily, dose 2

2021-03-09

Systemic reaction (other): Stomach Cramp at Diaphragm after vaccination.

2021-03-11

Systemic reaction (other): Had an itch swelled up three inches away from where it itched. Went away after an hour.

2021-03-12

Systemic reaction (other): Sluggish & Tired

Release 6 — day 14, dose 2

2021-03-22

Symptoms: Weight Gain, Increased Appetite this week like with steroids and a Bloody Nose Yesterday. Stomach Churns too. Idk? No fever chills or muscle aches to report. Breathing Great.

Release 7 — day 28, dose 2

2021-04-05

Symptoms: Marked Drowsiness and Fatigue today.Sneezing yesterday think it's allergies.

Release 9 — 6 months, dose 2

2021-09-06

Symptoms: Eye Aches, could be seasonal allergies. Definitely painful.

Release 11 — 6 months, dose 3

2022-02-11

Symptoms: Had a bleb rupture in my lung. Sent a blood clot to the rectum. Where it herniated. Not a good week.

Healthcare visit (other): Referral

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	Unevaluable event	·	·	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cystic lung disease	·	·	✓
SD	Epistaxis	✓	✓	✓
SD	Eye pain	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Increased appetite	✓	✓	✓
SD	Inguinal hernia	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Pyrexia	✓	✓	✓
SD	Sneezing	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Thrombosis	·	·	✓
SD	Weight increased	✓	✓	✓
SRO	Abdominal pain upper	✓	✓	✓
SRO	Ear swelling	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Nasal disorder	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Sluggishness	✓	✓	✓
SRO	Swelling	✓	✓	✓

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