582-22021-51696

4 vaccinations 16 coded responses 41 check-ins 16 free-text entries 1 call case

Sex: —
Age at first dose: 41-45
ZIP prefix: 220 / VA
Registered: 2021-02-03

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

Registered dependents

6UJ-24357-96458 Child or adolescent in my care · Male · 2021-11-06

RXF-26192-19140 Child or adolescent in my care · Female · 2021-11-06

Timeline

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

2021-01-30
Dose 1 — Pfizer-BioNTech
2021-02-03
Registered in v-safe
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenitis, Lymphadenopathy, Tenderness — Feeling: Good · Site: Pain

Free text: Same side, mildly tender, mobile submandibular lymphadenopathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy, Tenderness — Feeling: Fair · Site: Pain · Headache

Free text: Ipsi lateral, mildly tender, mobile facial lymphadenopathy persists

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — day 7, dose 1
MedDRA: Headache, Lymphadenopathy — Feeling: Good · Headache

Free text: HA improved, lymphadenopathy persists

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-22
Dose 2 — Pfizer-BioNTech
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Constipation, Photophobia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: Constipation, photophobia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-31
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-23
Survey response — 6 months, dose 2
MedDRA: Lethargy, Oropharyngeal pain — Feeling: Good

Free text: Sore throat and lethargy (no fever) about 3 weeks ago, lasting about 2-3d.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-05
Dose 3 — Pfizer-BioNTech
2021-10-06
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Loss of appetite

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Survey response — days 1–6 daily, dose 3
MedDRA: Breast tenderness, Dermatitis bullous, Dry eye, Rash — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Dry eye, Lbreast tenderness and bulbous rash on internal L knee.

MedDRA releases: 2024-11 · check-in free text available
2021-10-10
Survey response — days 1–6 daily, dose 3
MedDRA: Rash, Rash pruritic, Rash vesicular — Feeling: Fair · Site: Pain · Joint pains · Be unable to do your normal daily activities

Free text: Pruritic, Vesicular rash (now larger) on inner knees bilaterally

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Survey response — days 1–6 daily, dose 3
MedDRA: Rash, Rash vesicular — Feeling: Fair · Site: Pain · Joint pains · Be unable to do your normal daily activities

Free text: Vesicular rash, becoming diffuse, over knees bilaterally

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Survey response — day 7, dose 3
MedDRA: Rash, Rash pruritic, Rash vesicular — Feeling: Fair · Joint pains · Be unable to do your normal daily activities

Free text: Bilateral, pruritic, vesicular knee rash

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Survey response — day 14, dose 3
MedDRA: Rash, Rash pruritic, Rash vesicular — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pruritic, vesicular rash has spread from knees to forearms, torso, chest and jawline.

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Survey response — day 21, dose 3
MedDRA: Rash pruritic — Feeling: Good · 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: Pruritic rash that spread.

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Report sent to call center — day 21, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-28
Call 1 — Left Voicemail
2021-11-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-06
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-07
Survey response — 6 months, dose 3
MedDRA: Cough, Headache, Increased viscosity of upper respiratory secretion, Lacrimation increased, Nasopharyngitis, Pre-existing disease, Rhinorrhoea, Sneezing, Sputum discoloured — Feeling: Good

Free text: Normal cold and seasonal allergy symptoms (cough productive of thick green phlegm, sneeze, headache, watery eyes, cough productive of thin clear snot).

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Dose 4 — Pfizer-BioNTech
2022-06-02
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-06-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-04
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache · Be unable to do your normal daily activities

Adult check-in
2022-06-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-06-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-06-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-06-08
Health check-in — day 7, dose 4
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-06-17
Survey response — day 14, dose 4
MedDRA: Hypersensitivity, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Allergy flare and possible altitude sickness

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-29
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-06
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-15
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-31
Survey response — 3 months, dose 4
MedDRA: Abdominal pain, Chills, Diarrhoea, Fatigue, Gastrointestinal viral infection, Nausea, Pyrexia, Unevaluable event, Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: 24 hr GI bug: N/V/D, F/C/NS, abdominal cramping and fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-11-30
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-06-01
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Pfizer-BioNTech
2	2021-02-22	Pfizer-BioNTech
3	2021-10-05	Pfizer-BioNTech	No
4	2022-06-01	Pfizer-BioNTech	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-03

Systemic reaction (other): Same side, mildly tender, mobile submandibular lymphadenopathy

2021-02-05

Systemic reaction (other): Ipsi lateral, mildly tender, mobile facial lymphadenopathy persists

Release 3 — day 7, dose 1

2021-02-06

Systemic reaction (other): HA improved, lymphadenopathy persists

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Constipation, photophobia

Release 9 — 6 months, dose 2

2021-08-23

Symptoms: Sore throat and lethargy (no fever) about 3 weeks ago, lasting about 2-3d.

Release 10 — days 1–6 daily, dose 3

2021-10-06

Systemic reaction (other): Dizziness

2021-10-07

Systemic reaction (other): Loss of appetite

2021-10-08

Systemic reaction (other): Dry eye, Lbreast tenderness and bulbous rash on internal L knee.

2021-10-10

Systemic reaction (other): Pruritic, Vesicular rash (now larger) on inner knees bilaterally

2021-10-11

Systemic reaction (other): Vesicular rash, becoming diffuse, over knees bilaterally

Release 10 — day 7, dose 3

2021-10-12

Systemic reaction (other): Bilateral, pruritic, vesicular knee rash

Release 10 — day 14, dose 3

2021-10-19

Symptoms: Pruritic, vesicular rash has spread from knees to forearms, torso, chest and jawline.

Release 10 — day 21, dose 3

2021-10-26

Symptoms: Pruritic rash that spread.

Release 11 — 6 months, dose 3

2022-04-07

Symptoms: Normal cold and seasonal allergy symptoms (cough productive of thick green phlegm, sneeze, headache, watery eyes, cough productive of thin clear snot).

Release 12 — day 14, dose 4

2022-06-17

Symptoms: Allergy flare and possible altitude sickness

Release 12 — 3 months, dose 4

2022-08-31

Symptoms: 24 hr GI bug: N/V/D, F/C/NS, abdominal cramping and 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
SD	Abdominal pain	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal viral infection	·	·	✓
SD	Headache	·	·	✓
SD	Hypersensitivity	·	·	✓
SD	Increased viscosity of upper respiratory secretion	·	·	✓
SD	Lacrimation increased	·	·	✓
SD	Lethargy	✓	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rash	·	·	✓
SD	Rash pruritic	·	·	✓
SD	Rash vesicular	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sneezing	·	·	✓
SD	Sputum discoloured	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Vomiting	·	·	✓
SRO	Breast tenderness	·	·	✓
SRO	Constipation	✓	✓	✓
SRO	Decreased appetite	·	·	✓
SRO	Dermatitis bullous	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Dry eye	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Lymphadenitis	○	✓	○
SRO	Lymphadenopathy	✓	✓	✓
SRO	Photophobia	✓	✓	✓
SRO	Rash	·	·	✓
SRO	Rash pruritic	·	·	✓
SRO	Rash vesicular	·	·	✓
SRO	Tenderness	✓	·	✓

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