566-30839-26090

3 vaccinations 13 coded responses 34 check-ins 13 free-text entries 0 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 480 / MI
Registered: 2021-04-16

Relationship: Self
Race: Black or African American
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

2021-04-16
Registered in v-safe
2021-04-16
Dose 1 — Pfizer-BioNTech
2021-04-16
Survey response — day 0, dose 1
MedDRA: Conjunctivitis, Eyelid pain, Pre-existing disease — Feeling: Fair · Fever · Headache, Fatigue or tiredness

Free text: Aching in the outside corner of upper left eyelid where I have common occurrences of conjunctivitis from the Herpes Simplex virus. It is usually triggered by the onset of viral flu.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-23
Survey response — day 7, dose 1
MedDRA: Aggression, Anger, Fatigue, Headache, Mood altered — Feeling: Good

Free text: Experienced to date two episodes of moodiness or shortened temperament, probably brought on by the fatigue and headache. Both were moderate to severe.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-07
Dose 2 — Pfizer-BioNTech
2021-05-07
Health check-in — day 0, dose 2
Feeling: Fair · Site: Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Moderate brain fog.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Headache, Irritability — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Brain Fog- Moderate, Irritable! Noise or obnoxious odors & people escalate my headache pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: + brain fog. All three lessening in severity today. No NSAIDS or OTCs since 2nd dosage, just prescribed Lotrel, Metformin, Crestor & baby Aspirin daily.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Headache, Oversensing, Photophobia — Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Brain Fog. Irritable to moderate sounds, light stressors, then headache pain increases.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog — Feeling: Good · Headache, Fatigue or tiredness

Free text: Brain Fog too. All three actually less than moderate today, thanks to Monster drinks.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — day 7, dose 2
MedDRA: Brain fog — Feeling: Good · Headache

Free text: Brain Fog-mild.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-18
Health check-in — day 42, dose 2
Feeling: Good

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

Adult check-in
2021-11-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-14
Dose 3 — Pfizer-BioNTech
2021-11-15
Survey response — days 1–6 daily, dose 3
MedDRA: Body temperature decreased, Decreased appetite — Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Little to no appetite. 3:00 pm now and I've had nothing to eat yet. I will have something light anyway. My normal body temp runs 97.4 - 97.7 so 98.1 is elevated from vaccine booster. I have seen this temp many times before when fighting off illne

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No appetite

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-11-19
Survey response — days 1–6 daily, dose 3
MedDRA: No adverse event — Feeling: Good

Free text: None

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-28
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-05
Survey response — day 21, dose 3
MedDRA: Fatigue — Feeling: Good · Be unable to work or attend school

Free text: Extreme fatigue the morning after visiting a local Sam's Club.

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-19
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-26
Survey response — day 42, dose 3
MedDRA: Decreased appetite, Headache, Nausea, Vomiting — Feeling: Good

Free text: Bad nausea for one afternoon. Unmovable headache for a couple of days. 2 of 4 indoor only cats had loss of appetite for 24-48 hours. One threw up. She has not thrown up once in 2+ years.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-16	Pfizer-BioNTech
2	2021-05-07	Pfizer-BioNTech
3	2021-11-14	Pfizer-BioNTech	No

Free text

Release 7 — day 0, dose 1

2021-04-16

Systemic reaction (other): Aching in the outside corner of upper left eyelid where I have common occurrences of conjunctivitis from the Herpes Simplex virus. It is usually triggered by the onset of viral flu.

Release 7 — day 7, dose 1

2021-04-23

Systemic reaction (other): Experienced to date two episodes of moodiness or shortened temperament, probably brought on by the fatigue and headache. Both were moderate to severe.

Release 8 — days 1–6 daily, dose 2

2021-05-09

Systemic reaction (other): Moderate brain fog.

2021-05-10

Systemic reaction (other): Brain Fog- Moderate, Irritable! Noise or obnoxious odors & people escalate my headache pain.

2021-05-11

Systemic reaction (other): + brain fog. All three lessening in severity today. No NSAIDS or OTCs since 2nd dosage, just prescribed Lotrel, Metformin, Crestor & baby Aspirin daily.

2021-05-12

Systemic reaction (other): Brain Fog. Irritable to moderate sounds, light stressors, then headache pain increases.

2021-05-13

Systemic reaction (other): Brain Fog too. All three actually less than moderate today, thanks to Monster drinks.

Release 8 — day 7, dose 2

2021-05-14

Systemic reaction (other): Brain Fog-mild.

Release 10 — days 1–6 daily, dose 3

2021-11-15

Systemic reaction (other): Little to no appetite. 3:00 pm now and I've had nothing to eat yet. I will have something light anyway. My normal body temp runs 97.4 - 97.7 so 98.1 is elevated from vaccine booster. I have seen this temp many times before when fighting off illne cut off by CDC

2021-11-16

Systemic reaction (other): No appetite

2021-11-19

Systemic reaction (other): None

Release 10 — day 21, dose 3

2021-12-05

Symptoms: Extreme fatigue the morning after visiting a local Sam's Club.

Release 10 — day 42, dose 3

2021-12-26

Symptoms: Bad nausea for one afternoon. Unmovable headache for a couple of days. 2 of 4 indoor only cats had loss of appetite for 24-48 hours. One threw up. She has not thrown up once in 2+ years.

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	Decreased appetite	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Nausea	·	·	✓
SD	Vomiting	·	·	✓
SRO	Aggression	○	✓	○
SRO	Anger	✓	·	✓
SRO	Body temperature decreased	·	·	✓
SRO	Brain fog	✓	✓	✓
SRO	Conjunctivitis	✓	✓	✓
SRO	Decreased appetite	·	·	✓
SRO	Eyelid pain	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Mood altered	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Oversensing	✓	✓	✓
SRO	Photophobia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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