65B-21037-50170

3 vaccinations 7 coded responses 25 check-ins 7 free-text entries 2 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 342 / FL
Registered: 2020-12-29

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

Timeline

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

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Pfizer-BioNTech
2020-12-29
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fever · Muscle or body aches, Nausea

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Chills, Headache, Muscle or body aches

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Fatigue or tiredness

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-04
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-01-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-19
Survey response — day 21, dose 1
MedDRA: Balance disorder, Burning sensation, Paraesthesia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Imbalance, paresthesia of the upper and lower extremities, positive Roomberg. Lasted 4 days. There was a burning feeling on both lateral aspects of the upper limbs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-20
Dose 2 — Pfizer-BioNTech
2021-02-09
Survey response — day 14, dose 2
MedDRA: Paraesthesia — Feeling: Good

Free text: Paresthesias that are resolving

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 35, dose 2
Feeling: Good

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

Adult check-in
2021-03-23
Call 1 — Left Voicemail
2021-04-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-18
Dose 3 — Pfizer-BioNTech
2021-09-29
Survey response — day 7, dose 3
MedDRA: No adverse event — Feeling: Good

Free text: None

MedDRA releases: 2024-11 · check-in free text available
2021-10-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-16
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-01
Survey response — day 42, dose 3
MedDRA: Headache, Malaise, Pain, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Congestion, headache, malaise, body aches

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Survey response — 3 months, dose 3
MedDRA: SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school

Free text: Mild URI, Covid test was negative

MedDRA releases: 2024-11 · check-in free text available
2022-03-19
Survey response — 6 months, dose 3
MedDRA: COVID-19 — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Positive COVID 3/15/2022

MedDRA releases: 2024-11 · check-in free text available
2022-09-19
Survey response — 12 months, dose 3
MedDRA: COVID-19, Chest pain, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chest pain, increased fatigue. I had a negative CT coronary angiogram. Fatigue is attributed to COVID acquired in March 2022

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Pfizer-BioNTech
2	2021-01-20	Pfizer-BioNTech
3	2021-09-18	Pfizer-BioNTech	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 2 — day 21, dose 1

2021-01-19

Symptoms: Imbalance, paresthesia of the upper and lower extremities, positive Roomberg. Lasted 4 days. There was a burning feeling on both lateral aspects of the upper limbs

Release 3 — day 14, dose 2

2021-02-09

Symptoms: Paresthesias that are resolving

Release 9 — day 7, dose 3

2021-09-29

Systemic reaction (other): None

Release 10 — day 42, dose 3

2021-11-01

Symptoms: Congestion, headache, malaise, body aches

Release 10 — 3 months, dose 3

2021-12-18

Symptoms: Mild URI, Covid test was negative

Release 11 — 6 months, dose 3

2022-03-19

Symptoms: Positive COVID 3/15/2022

Release 12 — 12 months, dose 3

2022-09-19

Symptoms: Chest pain, increased fatigue. I had a negative CT coronary angiogram. Fatigue is attributed to COVID acquired in March 2022

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	Balance disorder	✓	✓	✓
SD	Burning sensation	✓	✓	✓
SD	Chest pain	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Malaise	·	·	✓
SD	Pain	·	·	✓
SD	Paraesthesia	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	No adverse event	·	·	✓

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