69H-23428-23429

4 vaccinations 7 coded responses 29 check-ins 7 free-text entries 0 call cases

Sex: Male
Age at first dose: 36-40
ZIP prefix: 974 / OR
Registered: 2021-04-09

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

Registered dependents

HQZ-36370-77643 Child or adolescent in my care · Female · 2022-06-25

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-04-09
Registered in v-safe
2021-04-09
Dose 1 — Pfizer-BioNTech
2021-04-09
Survey response — day 0, dose 1
MedDRA: Feeling abnormal — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Mild mental fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Fatigue — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Fatigue and slight light headedness that came on in afternoon, following no symptoms and a strenuous activity

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-05
Dose 2 — Pfizer-BioNTech
2021-05-05
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mental fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — days 1–6 daily, dose 2
MedDRA: Contusion — Feeling: Fair · Fatigue or tiredness

Free text: Dramatic bruise on elbow of vaccinated arm; maybe coincidence (I did some physical labor) but have no memory of any injury that would normally lead to such a bruise. Perhaps a greater likelihood of bruising due to the body's immunoresponse to the vaccine?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-19
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-02
Survey response — day 28, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair

Free text: An outbreak of canker sores (but I don't think it's vaccine related)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-18
Dose 3 — Pfizer-BioNTech
2022-05-05
Survey response — 12 months, dose 2
MedDRA: Nasopharyngitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Caught a couple colds, unrelated to COVID-19

MedDRA releases: 2024-11 · check-in free text available
2022-06-18
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-17
Dose 4 — Pfizer-BioNTech
2022-12-20
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2022-12-20
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-22
Survey response — day 35, dose 4
MedDRA: Paranasal sinus discomfort, Sinus congestion, Sinusitis — Feeling: Fair

Free text: Just stuffy/scratchy/inflamed sinuses, but could be related to molds and poor sleep

MedDRA releases: 2024-11 · check-in free text available
2022-12-29
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-02-16
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-05-18
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-09	Pfizer-BioNTech
2	2021-05-05	Pfizer-BioNTech
3	2021-12-18	Pfizer-BioNTech	No
4	2022-11-17	Pfizer-BioNTech	No

Free text

Release 7 — day 0, dose 1

2021-04-09

Systemic reaction (other): Mild mental fog

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): Fatigue and slight light headedness that came on in afternoon, following no symptoms and a strenuous activity

Release 8 — days 1–6 daily, dose 2

2021-05-06

Systemic reaction (other): Mental fog

2021-05-08

Systemic reaction (other): Dramatic bruise on elbow of vaccinated arm; maybe coincidence (I did some physical labor) but have no memory of any injury that would normally lead to such a bruise. Perhaps a greater likelihood of bruising due to the body's immunoresponse to the vaccine?

Release 8 — day 28, dose 2

2021-06-02

Symptoms: An outbreak of canker sores (but I don't think it's vaccine related)

Release 11 — 12 months, dose 2

2022-05-05

Symptoms: Caught a couple colds, unrelated to COVID-19

Release 12 — day 35, dose 4

2022-12-22

Symptoms: Just stuffy/scratchy/inflamed sinuses, but could be related to molds and poor sleep

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	Condition aggravated	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sinus congestion	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Contusion	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓

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