5Q5-77288-09787

3 vaccinations 13 coded responses 31 check-ins 13 free-text entries 4 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 970 / OR
Registered: 2021-01-15

Relationship: Self
Race: Multiracial
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
Registered in v-safe
2021-01-15
Dose 1 — Pfizer-BioNTech
2021-01-15
Health check-in — day 0, dose 1
Feeling: Good · Fever · None

Adult check-in
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain, Swelling

Free text: sore throat, mild, for a few hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Sinus congestion — Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: sinus congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — day 7, dose 1
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-02
Dose 2 — Pfizer-BioNTech
2021-02-02
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Urticaria — Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, 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

Free text: Hives and severe itching on arm that received injection, and on lower back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Urticaria — Feeling: Good · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, 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

Free text: Hives and severe itching on arms and all over my back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, 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
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Urticaria — Feeling: Fair · Fever · Headache, 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

Free text: Hives and severe itching on arms and all over my back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 7, dose 2
MedDRA: Fatigue, Pruritus — Feeling: Good · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: When the severe itching mostly ended 02/08, fatigue increased. By 02/09, the fatigue decreased.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — day 14, dose 2
MedDRA: Rash — Feeling: Good

Free text: Rash on face 9 to 12 days after the second dose of vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — day 21, dose 2
MedDRA: Rash, Self-medication — Feeling: Good

Free text: Still getting over the very itchy rash on my back from following the 2nd dose. I have to take 5 Benadryl tablets every night the itching is so bad. I've never experienced such symptoms before. My father has similar symptoms after his 2nd dose too.

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

Adult check-in
2021-03-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-21
Dose 3 — Moderna
Co-administered: Flu
2022-01-03
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2022-01-04
Survey response — day 14, dose 3
MedDRA: Headache, Injection site bruising, Injection site pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Pain has returned to the nasty-looking bruise surrounding the injection site. Severe headache.

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Survey response — day 21, dose 3
MedDRA: Arthralgia, Headache, Rash, Rash vesicular, Sinus congestion, Urticaria — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: #NAME?

MedDRA releases: 2024-11 · check-in free text available
2022-01-18
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-25
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-01
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-21
Survey response — 6 months, dose 3
MedDRA: Hypoaesthesia, Oropharyngeal pain — Feeling: Fair · Be unable to work or attend school, 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

Free text: severely-painful sore throat, severe numbness in left leg and foot

MedDRA releases: 2024-11 · check-in free text available
2022-06-21
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-22
Call 2 — Left Voicemail
2022-12-21
Survey response — 12 months, dose 3
MedDRA: Arthralgia, Hypoxia, Pain, Pharyngeal haemorrhage, Unevaluable event — 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

Free text: Symptoms: Extremely severe body aches in my large joints for the last 14 days, difficulty getting enough oxygen, bleeding from throat. · Healthcare visit (other): Unable to afford health coverage, and stranded by snow and ice

MedDRA releases: 2024-11 · check-in free text available
2022-12-21
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-12-22
Call 3 — Could Not Reach Participant
2022-12-22
Call 2 — Could Not Reach Participant
2023-01-17
Call 1 — Could Not Reach Participant
2023-01-17
Call 1 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Pfizer-BioNTech
2	2021-02-02	Pfizer-BioNTech
3	2021-12-21	Moderna	Flu

Call center

4 call center cases

2 unsuccessful · 2 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-16

Systemic reaction (other): sore throat, mild, for a few hours

2021-01-17

Systemic reaction (other): sinus congestion

2021-01-21

Systemic reaction (other): Dizziness

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Hives and severe itching on arm that received injection, and on lower back

2021-02-06

Systemic reaction (other): Hives and severe itching on arms and all over my back

2021-02-08

Systemic reaction (other): Hives and severe itching on arms and all over my back

Release 4 — day 7, dose 2

2021-02-10

Systemic reaction (other): When the severe itching mostly ended 02/08, fatigue increased. By 02/09, the fatigue decreased.

Release 4 — day 14, dose 2

2021-02-16

Symptoms: Rash on face 9 to 12 days after the second dose of vaccine.

Release 4 — day 21, dose 2

2021-02-24

Symptoms: Still getting over the very itchy rash on my back from following the 2nd dose. I have to take 5 Benadryl tablets every night the itching is so bad. I've never experienced such symptoms before. My father has similar symptoms after his 2nd dose too.

Release 10 — day 14, dose 3

2022-01-04

Symptoms: Pain has returned to the nasty-looking bruise surrounding the injection site. Severe headache.

Release 10 — day 21, dose 3

2022-01-11

Symptoms: #NAME?

Release 12 — 6 months, dose 3

2022-06-21

Symptoms: severely-painful sore throat, severe numbness in left leg and foot

Release 12 — 12 months, dose 3

2022-12-21

Symptoms: Extremely severe body aches in my large joints for the last 14 days, difficulty getting enough oxygen, bleeding from throat.

Healthcare visit (other): Unable to afford health coverage, and stranded by snow and ice

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	Unevaluable event	·	·	✓
SD	Arthralgia	·	·	✓
SD	Headache	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Hypoxia	·	·	✓
SD	Injection site bruising	·	·	✓
SD	Injection site pain	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pharyngeal haemorrhage	·	·	✓
SD	Rash	✓	✓	✓
SD	Rash vesicular	·	·	✓
SD	Self-medication	✓	✓	✓
SD	Sinus congestion	·	·	✓
SD	Urticaria	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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