5G4-14672-08269

2 vaccinations 8 coded responses 15 check-ins 8 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 762 / TX
Registered: 2021-03-09

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

2021-03-09
Registered in v-safe
2021-03-09
Dose 1 — Pfizer-BioNTech
2021-03-09
Health check-in — day 0, dose 1
Feeling: Fair · Headache

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Irritability — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Irritable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Gait disturbance, Unevaluable event — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Difficulty walking · Healthcare visit (other): Left a urine sample

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Decreased appetite, Urine output decreased — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Low urine output. No desire to eat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Urinary tract disorder — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Urinary issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — day 7, dose 1
MedDRA: Anxiety — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Anxiety

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Dose 2 — Pfizer-BioNTech
2021-04-20
Survey response — day 14, dose 2
MedDRA: Dizziness, Fatigue, Malaise, Nausea, Office visit, Oropharyngeal pain, Pyrexia, Urinary tract infection, Vaccine positive rechallenge — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: UTI following both shots. With second one I have been sick over 14 days, multiple doctors visits. Nausea persistent for over 2 weeks. Fever gone. Sore throat gone. Dizziness mostly gone. Exhausted daily. · Healthcare visit (other): Home Health visit (doctor appt)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — day 14, 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)
2021-04-21
Survey response — day 21, dose 2
MedDRA: Gastrointestinal disorder, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Continued stomach issues... specifically Nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-30
Survey response — 3 months, dose 2
MedDRA: Mental disorder — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Overall health decline, mental health decline past 2 to 3 months

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-30
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-06
Call 1 — Could Not Reach Participant
2021-07-09
Call 2 — Could Not Reach Participant
2021-07-14
Call 3 — Could Not Reach Participant
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Pfizer-BioNTech
2	2021-03-31	Pfizer-BioNTech

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Irritable

2021-03-12

Systemic reaction (other): Difficulty walking

Healthcare visit (other): Left a urine sample

2021-03-13

Systemic reaction (other): Low urine output. No desire to eat

2021-03-14

Systemic reaction (other): Urinary issues

Release 5 — day 7, dose 1

2021-03-16

Systemic reaction (other): Anxiety

Release 7 — day 14, dose 2

2021-04-20

Symptoms: UTI following both shots. With second one I have been sick over 14 days, multiple doctors visits. Nausea persistent for over 2 weeks. Fever gone. Sore throat gone. Dizziness mostly gone. Exhausted daily.

Healthcare visit (other): Home Health visit (doctor appt)

Release 7 — day 21, dose 2

2021-04-21

Symptoms: Continued stomach issues... specifically Nausea

Release 9 — 3 months, dose 2

2021-06-30

Symptoms: Overall health decline, mental health decline past 2 to 3 months

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	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Mental disorder	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Urinary tract infection	✓	✓	✓
SD	Vaccine positive rechallenge	✓	✓	✓
SRO	Anxiety	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Gait disturbance	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Urinary tract disorder	✓	✓	✓
SRO	Urine output decreased	✓	✓	✓

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