57G-21264-93747

3 vaccinations 10 coded responses 24 check-ins 10 free-text entries 6 call cases

Sex: Male
Age at first dose: 31-35
ZIP prefix: 021 / MA
Registered: 2021-01-31

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

Timeline

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

2021-01-15
Dose 1 — Pfizer-BioNTech
2021-01-31
Registered in v-safe
2021-01-31
Survey response — day 14, dose 1
MedDRA: Injection site dryness, Injection site reaction — Feeling: Fair

Free text: Arm having localized reaction. Started as small hole and dry skin at site of injection on day 7, has gotten bigger and deeper but doesnt hurt and isnt draining anything.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — day 21, dose 1
MedDRA: Erythema, Injection site erythema, Injection site swelling, Rash, Rash erythematous, Rash papular — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diffuse rash: clusters of small red raised bumps & red skin around them, located above left armpit, on left ribcage around stomach to back, & right forearm. Less on legs/chest (1-5 bumps each). Local injection site red/swell still growing in diameter

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Dose 2 — Pfizer-BioNTech
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction, Office visit, Pityriasis rosea, Reaction to previous exposure to any vaccine — Feeling: Fair · Site: Pain, Swelling · Rash, not including the immediate area around the injection site · Be unable to work, 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: Systemic reaction (other): I was diagnosed as having a very rare immune reaction to the first dose. (severe Pityriasis rosea full body). Nonetheless, I received the second dose and the rash has gotten somewhat worse. Derm COVID/VAX specialists are following up with me. We have decided to treat with steroid cream and Allegra 2x per day without anti-viral to ensure vaccine efficacy. · Healthcare visit (other): Specialist virtual visit with high resolution photos provided to physician prior to meeting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection site · Be unable to work, 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: Please see prior note on last report.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): See prior report · Healthcare visit (other): See prior report

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Type IV hypersensitivity reaction, Unevaluable event — Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): See prior comment - diagnosed as delayed immune reaction to 1st dose, still persists and spreading. · Healthcare visit (other): See prior report.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-16
Survey response — day 7, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: See prior report for details

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-23
Survey response — day 14, dose 2
MedDRA: Rash — Feeling: Fair · 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: Worsening rash

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-02
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-31
Call 1 — Left Voicemail
2021-08-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-18
Dose 3 — Pfizer-BioNTech
2022-02-19
Survey response — days 1–6 daily, dose 3
MedDRA: Bone pain, Hyperhidrosis — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: deep bone pain & sweats

MedDRA releases: 2024-11 · check-in free text available
2022-02-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-02-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea

Adult check-in
2022-02-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Diarrhea

Adult check-in
2022-02-25
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-03-04
Survey response — day 14, dose 3
MedDRA: Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-03-11
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-03-18
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-05-20
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-08-20
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Pfizer-BioNTech
2	2021-02-09	Pfizer-BioNTech
3	2022-02-18	Pfizer-BioNTech	No

Call center

6 call center cases

6 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — day 14, dose 1

2021-01-31

Symptoms: Arm having localized reaction. Started as small hole and dry skin at site of injection on day 7, has gotten bigger and deeper but doesnt hurt and isnt draining anything.

Release 3 — day 21, dose 1

2021-02-05

Symptoms: Diffuse rash: clusters of small red raised bumps & red skin around them, located above left armpit, on left ribcage around stomach to back, & right forearm. Less on legs/chest (1-5 bumps each). Local injection site red/swell still growing in diameter cut off by CDC

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): I was diagnosed as having a very rare immune reaction to the first dose. (severe Pityriasis rosea full body). Nonetheless, I received the second dose and the rash has gotten somewhat worse. Derm COVID/VAX specialists are following up with me. We have decided to treat with steroid cream and Allegra 2x per day without anti-viral to ensure vaccine efficacy.

Healthcare visit (other): Specialist virtual visit with high resolution photos provided to physician prior to meeting

2021-02-13

Systemic reaction (other): Please see prior note on last report.

2021-02-14

Systemic reaction (other): See prior report

Healthcare visit (other): See prior report

2021-02-15

Systemic reaction (other): See prior comment - diagnosed as delayed immune reaction to 1st dose, still persists and spreading.

Healthcare visit (other): See prior report.

Release 4 — day 7, dose 2

2021-02-16

Systemic reaction (other): See prior report for details

Release 4 — day 14, dose 2

2021-02-23

Symptoms: Worsening rash

Release 11 — days 1–6 daily, dose 3

2022-02-19

Systemic reaction (other): deep bone pain & sweats

Release 11 — day 14, dose 3

2022-03-04

Symptoms: Fatigue

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	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Injection site dryness	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site reaction	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Rash papular	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Bone pain	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Pityriasis rosea	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	✓	✓	✓
SRO	Type IV hypersensitivity reaction	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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