4UB-88175-76466

3 vaccinations 15 coded responses 38 check-ins 15 free-text entries 0 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 541 / WI
Registered: 2021-01-25

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-25
Registered in v-safe
2021-01-25
Dose 1 — Pfizer-BioNTech
2021-01-25
Survey response — day 0, dose 1
MedDRA: Feeling hot — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Slightly warm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-15
Dose 2 — Pfizer-BioNTech
2021-02-15
Health check-in — day 0, dose 2
Feeling: Good · Fever · Chills

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dry cough that lasted about an hour

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Good · Fatigue or tiredness

Free text: Ringing in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Nausea

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-15
Survey response — day 28, dose 2
MedDRA: Chills — Feeling: Good

Free text: On occasion experienced chills. Symptoms only lasted a few hours. Had several episodes of this but have not had anything for several days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-29
Survey response — day 42, dose 2
MedDRA: Abscess, Diverticulitis, Hospitalisation — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Diverticulitis with abscess. In hospital 3 days and (b)(6) up nights. Believe unrelated to vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Survey response — 3 months, dose 2
MedDRA: Tinnitus, Vision blurred — Feeling: Good

Free text: Ringing in ear primarily the left ear. Some blurred vision at times but not sure it is related to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Dose 3 — Pfizer-BioNTech
2021-09-30
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-01
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-10-02
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Slight ringing in ears

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Loss of appetite

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Fair · Nausea

Free text: Tinititis

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus, Vertigo — Feeling: Fair · Nausea · Be unable to do your normal daily activities

Free text: tinitis, vertigo

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Tinitis

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Survey response — day 7, dose 3
MedDRA: Tinnitus — Feeling: Fair · Fatigue or tiredness

Free text: Tinitis

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-21
Survey response — day 21, dose 3
MedDRA: Arthralgia, Tinnitus — Feeling: Good

Free text: Tinnitus, knee joint pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-04
Survey response — day 35, dose 3
MedDRA: Tinnitus — Feeling: Good

Free text: Tinitis

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Survey response — day 42, dose 3
MedDRA: Tinnitus — Feeling: Good

Free text: Tinitis

MedDRA releases: 2024-11 · check-in free text available
2022-03-31
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-30
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-25	Pfizer-BioNTech
2	2021-02-15	Pfizer-BioNTech
3	2021-09-30	Pfizer-BioNTech	No

Free text

Release 2 — day 0, dose 1

2021-01-25

Systemic reaction (other): Slightly warm

Release 4 — days 1–6 daily, dose 2

2021-02-16

Systemic reaction (other): Dry cough that lasted about an hour

2021-02-18

Systemic reaction (other): Ringing in ears

Release 5 — day 28, dose 2

2021-03-15

Symptoms: On occasion experienced chills. Symptoms only lasted a few hours. Had several episodes of this but have not had anything for several days.

Release 6 — day 42, dose 2

2021-03-29

Symptoms: Diverticulitis with abscess. In hospital 3 days and (b)(6) up nights. Believe unrelated to vaccine.

redacted (b)(6)

Release 8 — 3 months, dose 2

2021-05-17

Symptoms: Ringing in ear primarily the left ear. Some blurred vision at times but not sure it is related to the vaccine.

Release 9 — days 1–6 daily, dose 3

2021-10-02

Systemic reaction (other): Slight ringing in ears

2021-10-03

Systemic reaction (other): Loss of appetite

2021-10-04

Systemic reaction (other): Tinititis

Release 10 — days 1–6 daily, dose 3

2021-10-05

Systemic reaction (other): tinitis, vertigo

2021-10-06

Systemic reaction (other): Tinitis

Release 10 — day 7, dose 3

2021-10-07

Systemic reaction (other): Tinitis

Release 10 — day 21, dose 3

2021-10-21

Symptoms: Tinnitus, knee joint pain

Release 10 — day 35, dose 3

2021-11-04

Symptoms: Tinitis

Release 10 — day 42, dose 3

2021-11-11

Symptoms: Tinitis

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	Abscess	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Chills	✓	✓	✓
SD	Diverticulitis	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SD	Vision blurred	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Decreased appetite	·	·	✓
SRO	Feeling hot	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Vertigo	·	·	✓

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