5MM-75588-98911

4 vaccinations 14 coded responses 53 check-ins 14 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 920 / CA
Registered: 2021-02-03

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

2021-02-03
Registered in v-safe
2021-02-03
Dose 1 — Pfizer-BioNTech
2021-02-03
Health check-in — day 0, dose 1
Feeling: Fair · Fever · Joint pains, Muscle or body aches

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Malaise — Feeling: Fair · Joint pains, Muscle or body aches

Free text: Just mild general malaise

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: Malaise — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Slightly more general malaise than yesterday on this #3 day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-02-10
Health check-in — day 7, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-02-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-24
Dose 2 — Pfizer-BioNTech
2021-02-24
Health check-in — day 0, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Rhinorrhoea — Feeling: Poor · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mild URI Sx. Runny nose tearing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory symptom — Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches

Free text: URI Sx are much less than yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory symptom, Rhinorrhoea — Feeling: Fair · Site: Pain, Itching · Muscle or body aches

Free text: URI Sx runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Rhinorrhoea, Upper respiratory tract infection — Feeling: Good · Site: Itching · Joint pains

Free text: URI runny nose abated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 21, dose 2
MedDRA: Arthralgia, Injection site pruritus, Malaise, Pain — Feeling: Good

Free text: Still some mild malaise and occasional body/joint aches. Arm itches some at vaccination site/ but no redness. The moderate joint pains have abated in ankles ans shins. Pretty good week.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-28
Dose 3 — Pfizer-BioNTech
2021-09-28
Survey response — day 0, dose 3
MedDRA: Malaise — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: General malaise

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-09-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-12
Survey response — day 14, dose 3
MedDRA: Nasal discomfort, Rhinorrhoea, Sneezing — Feeling: Good

Free text: 2 days of moderate nasal irritation, clear discharge & sneezing (like allergy).but no apparent allergen; lessens & subsides by afternoon.

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-29
Survey response — 3 months, dose 3
MedDRA: Nasal discomfort, Nasopharyngitis, Rhinorrhoea, Sneezing — Feeling: Good

Free text: Several days of nasal irritation, sneezing and runny nose (clear)...like a mild cold. Did not progress with any other symptoms; no fever; no loss of smell.

MedDRA releases: 2024-11 · check-in free text available
2022-03-30
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-10
Dose 4 — Pfizer-BioNTech
2022-04-10
Health check-in — day 0, dose 4
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2022-04-11
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Itching · Fever · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-04-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-04-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-04-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-04-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-04-17
Health check-in — day 7, dose 4
Feeling: Fair · Site: Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2022-04-24
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-02
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-10
Survey response — day 28, dose 4
MedDRA: Dermatitis allergic, Injection site rash, Rash, Rash pruritic — Feeling: Good

Free text: Scattered alleergic-type skin rash on legs, chest, shoulders (including left arm vaccination sites)...mild, but itchy.

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Survey response — day 35, dose 4
MedDRA: Rash pruritic — Feeling: Good

Free text: Mild, scattered rash continues, but no worse (itchy).

MedDRA releases: 2024-11 · check-in free text available
2022-05-23
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-12
Survey response — 3 months, dose 4
MedDRA: Rash, Viral rash — Feeling: Fair

Free text: Zero COVID sx. No effects from first 3 Pfizer vac. Developed persistent rash limited to ANT body, arms,legs (viral exanthem type)- not relieved by any topical treatment. No systemic or constitutional symptoms are felt.

MedDRA releases: 2024-11 · check-in free text available
2022-10-11
Survey response — 6 months, dose 4
MedDRA: Blister, Hospitalisation, Living in residential institution, Oedema, Pemphigoid, Rash — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: After 4th dose(boost#2)on 10 April: 3 weeks later: anterior body rash X4 months, that went to arms&legs. Sept with acute leg/foot rash, 2+ edema with giant bullae. Hospitalized 29 -navy Hosp; now care facility. Dx: probably bullous pemphigoid/on Rx.

MedDRA releases: 2024-11 · check-in free text available
2022-10-11
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Hospitalization · 1 call case(s)
2022-10-12
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-13
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Pfizer-BioNTech
2	2021-02-24	Pfizer-BioNTech
3	2021-09-28	Pfizer-BioNTech	No
4	2022-04-10	Pfizer-BioNTech	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): Just mild general malaise

2021-02-05

Systemic reaction (other): Slightly more general malaise than yesterday on this #3 day

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): Mild URI Sx. Runny nose tearing

2021-02-26

Systemic reaction (other): URI Sx are much less than yesterday.

2021-03-01

Systemic reaction (other): URI Sx runny nose

2021-03-02

Systemic reaction (other): URI runny nose abated

Release 5 — day 21, dose 2

2021-03-18

Symptoms: Still some mild malaise and occasional body/joint aches. Arm itches some at vaccination site/ but no redness. The moderate joint pains have abated in ankles ans shins. Pretty good week.

Release 9 — day 0, dose 3

2021-09-28

Systemic reaction (other): General malaise

Release 10 — day 14, dose 3

2021-10-12

Symptoms: 2 days of moderate nasal irritation, clear discharge & sneezing (like allergy).but no apparent allergen; lessens & subsides by afternoon.

Release 10 — 3 months, dose 3

2021-12-29

Symptoms: Several days of nasal irritation, sneezing and runny nose (clear)...like a mild cold. Did not progress with any other symptoms; no fever; no loss of smell.

Release 11 — day 28, dose 4

2022-05-10

Symptoms: Scattered alleergic-type skin rash on legs, chest, shoulders (including left arm vaccination sites)...mild, but itchy.

Release 11 — day 35, dose 4

2022-05-18

Symptoms: Mild, scattered rash continues, but no worse (itchy).

Release 12 — 3 months, dose 4

2022-07-12

Symptoms: Zero COVID sx. No effects from first 3 Pfizer vac. Developed persistent rash limited to ANT body, arms,legs (viral exanthem type)- not relieved by any topical treatment. No systemic or constitutional symptoms are felt.

Release 12 — 6 months, dose 4

2022-10-11

Symptoms: After 4th dose(boost#2)on 10 April: 3 weeks later: anterior body rash X4 months, that went to arms&legs. Sept with acute leg/foot rash, 2+ edema with giant bullae. Hospitalized 29 -navy Hosp; now care facility. Dx: probably bullous pemphigoid/on Rx. cut off by CDC

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	Arthralgia	✓	✓	✓
SD	Blister	·	·	✓
SD	Dermatitis allergic	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site rash	·	·	✓
SD	Living in residential institution	·	·	✓
SD	Malaise	✓	✓	✓
SD	Nasal discomfort	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oedema	·	·	✓
SD	Pain	✓	✓	✓
SD	Pemphigoid	·	·	✓
SD	Rash	·	·	✓
SD	Rash pruritic	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sneezing	·	·	✓
SD	Viral rash	·	·	✓
SRO	Malaise	✓	✓	✓
SRO	Respiratory symptom	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Upper respiratory tract infection	✓	✓	✓

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