6D5-29006-85116

4 vaccinations 18 coded responses 35 check-ins 17 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 000
Registered: 2020-12-31

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

2020-12-31
Registered in v-safe
2020-12-31
Dose 1 — Pfizer-BioNTech
2020-12-31
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches

Adult check-in
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Productive cough — Feeling: Good

Free text: Coughing lots of phlem. More than usual.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Health check-in — day 7, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-01-15
Survey response — day 14, dose 1
MedDRA: Headache, Oropharyngeal pain — Feeling: Good

Free text: Headache and sore throat. Both mild.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Dose 2 — Pfizer-BioNTech
2021-01-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-01-28
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Survey response — day 14, dose 2
MedDRA: Dizziness — Feeling: Good · Be unable to do your normal daily activities

Free text: Light headed, Dizzy

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

Adult check-in
2021-02-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-25
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Tired even after a good night's sleep.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-04-22
Survey response — 3 months, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Loss of air. Concentrator increased. EXPEC, echinasea. OSHA, lots of rest 6 - 10 April. Still shorter on air than before April. Don't know if it is related to shot or Covid.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-22
Survey response — 6 months, dose 2
MedDRA: Basal cell carcinoma — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Multiple Basil Cells. Just finished 2 weeks fluorouracil. Head looks like a tomato.Don't think it has anything to do with Covid shot.

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Dose 3 — Moderna
2022-01-21
Survey response — 12 months, dose 2
MedDRA: Condition aggravated, Pre-existing disease, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I have COPD. It seems to be getting worse. I now use 4 on my portable if I am walking or talking. Probably more due to stress than anything. I am very reluctant to go to doctors for on going problems. COPD, AMD, basil cells, arthritis, etc. · Healthcare visit (other): NONE

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-27
Call 1 — Left Voicemail
2022-04-28
Dose 4 — Moderna
2022-04-30
Survey response — days 1–6 daily, dose 4
MedDRA: Adverse reaction — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: Feels like when I had pneumonia.

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Survey response — days 1–6 daily, dose 4
MedDRA: Nausea, Pyrexia — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Free text: Fever broke last night about 22:00. Queazy stomach, probably from messed up diet.

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Survey response — days 1–6 daily, dose 4
MedDRA: Headache — Feeling: Good · Site: Pain · Headache

Free text: Headache maybe related to polin.

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Survey response — days 1–6 daily, dose 4
MedDRA: Headache — Feeling: Good · Headache

Free text: Don't think headache is related to vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Survey response — days 1–6 daily, dose 4
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Chest congestion probably not related to vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-12
Survey response — day 14, dose 4
MedDRA: Pyrexia — Feeling: Good

Free text: Low grade fever. Assuming it is from polin, etc.

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Survey response — day 21, dose 4
MedDRA: Headache, Medical counselling, Pre-existing disease, Respiratory disorder — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Allergies probably. Headaches & breathing problems seem to follow pollen count. Still not over reaction to Cetrizine. · Healthcare visit (other): Called doctor assistant. Told to drop Cetrizine

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Report sent to call center — day 21, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-20
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-20
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-26
Survey response — day 28, dose 4
MedDRA: Cough, Fatigue, Secretion discharge, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: What I thought was allergies matches a few persons whose doctors told them it was a weird cold that is going around. Yesterday coughed up 1 to 2 cups {150 to 200 cc's} of mucus. Today is more normal-10 to 20 cc's. Temp generally normal or low. Tired. · Healthcare visit (other): Afraid to try to go to ER

MedDRA releases: 2024-11 · check-in free text available
2022-05-26
Report sent to call center — day 28, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-27
Call 2 — Left Voicemail
2022-05-27
Call 1 — Left Voicemail
2022-05-27
Call 1 — Left Voicemail
2022-06-02
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-09
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-28
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-27
Survey response — 6 months, dose 4
MedDRA: Arthralgia, Pain in extremity — Feeling: Good

Free text: Arn & shoulder joint pain

MedDRA releases: 2024-11 · check-in free text available
2023-04-28
Survey response — 12 months, dose 4
MedDRA: Decreased appetite, Dyspnoea, Hepatic function abnormal — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Pfizer-BioNTech
2	2021-01-21	Pfizer-BioNTech
3	2021-11-02	Moderna	No
4	2022-04-28	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-03

Systemic reaction (other): Sore throat

2021-01-04

Systemic reaction (other): Coughing lots of phlem. More than usual.

Release 2 — day 14, dose 1

2021-01-15

Symptoms: Headache and sore throat. Both mild.

Release 3 — day 14, dose 2

2021-02-04

Symptoms: Light headed, Dizzy

Release 4 — day 35, dose 2

2021-02-25

Symptoms: Tired even after a good night's sleep.

Release 7 — 3 months, dose 2

2021-04-22

Symptoms: Loss of air. Concentrator increased. EXPEC, echinasea. OSHA, lots of rest 6 - 10 April. Still shorter on air than before April. Don't know if it is related to shot or Covid.

Release 9 — 6 months, dose 2

2021-07-22

Symptoms: Multiple Basil Cells. Just finished 2 weeks fluorouracil. Head looks like a tomato.Don't think it has anything to do with Covid shot.

Release 11 — 12 months, dose 2

2022-01-21

Symptoms: I have COPD. It seems to be getting worse. I now use 4 on my portable if I am walking or talking. Probably more due to stress than anything. I am very reluctant to go to doctors for on going problems. COPD, AMD, basil cells, arthritis, etc.

Healthcare visit (other): NONE

Release 11 — days 1–6 daily, dose 4

2022-04-30

Systemic reaction (other): Feels like when I had pneumonia.

2022-05-01

Systemic reaction (other): Fever broke last night about 22:00. Queazy stomach, probably from messed up diet.

2022-05-02

Systemic reaction (other): Headache maybe related to polin.

2022-05-03

Systemic reaction (other): Don't think headache is related to vaccine.

2022-05-04

Systemic reaction (other): Chest congestion probably not related to vaccine

Release 11 — day 14, dose 4

2022-05-12

Symptoms: Low grade fever. Assuming it is from polin, etc.

Release 11 — day 21, dose 4

2022-05-19

Symptoms: Allergies probably. Headaches & breathing problems seem to follow pollen count. Still not over reaction to Cetrizine.

Healthcare visit (other): Called doctor assistant. Told to drop Cetrizine

Release 11 — day 28, dose 4

2022-05-26

Symptoms: What I thought was allergies matches a few persons whose doctors told them it was a weird cold that is going around. Yesterday coughed up 1 to 2 cups {150 to 200 cc's} of mucus. Today is more normal-10 to 20 cc's. Temp generally normal or low. Tired. cut off by CDC

Healthcare visit (other): Afraid to try to go to ER

Release 12 — 6 months, dose 4

2022-10-27

Symptoms: Arn & shoulder joint pain

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	Medical counselling	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	·	·	✓
SD	Basal cell carcinoma	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Cough	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hepatic function abnormal	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Secretion discharge	·	·	✓
SRO	Adverse reaction	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Headache	·	·	✓
SRO	Nausea	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Productive cough	✓	✓	✓
SRO	Pyrexia	·	·	✓
SRO	Respiratory tract congestion	·	·	✓

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