6X7-10508-29733

4 vaccinations 10 coded responses 29 check-ins 10 free-text entries 1 call case

Sex: Male
Age at first dose: 36-40
ZIP prefix: 662 / KS
Registered: 2021-01-31

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

Registered dependents

2VF-23745-91992 Child or adolescent in my care · Female · 2022-06-29

3RW-18606-27046 Child or adolescent in my care · Female · 2022-06-29

KXW-26483-99073 Adult relative or friend · Female · 2022-07-14

Timeline

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

2021-01-26
Dose 1 — Pfizer-BioNTech
2021-01-31
Registered in v-safe
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

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

Adult check-in
2021-02-04
Survey response — day 7, dose 1
MedDRA: Headache, Pre-existing disease — Feeling: Good · Headache · Be unable to work, Be unable to do your normal daily activities

Free text: I get chronic headaches, so probably not related to vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-16
Dose 2 — Pfizer-BioNTech
2021-02-16
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-24
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-09-25
Survey response — days 1–6 daily, dose 3
MedDRA: Blood pressure increased, Heart rate increased, Palpitations — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Mildly to moderately elevated blood pressure and heart rate that felt like palpitations (but wasn't)

MedDRA releases: 2024-11 · check-in free text available
2021-09-25
Survey response — day 0, dose 3
MedDRA: Dizziness, Immediate post-injection reaction, Palpitations — Feeling: Fair

Free text: Heart palpitations, light headed starting 5 minutes after jab, lasting 4 hours.

MedDRA releases: 2024-11 · check-in free text available
2021-09-27
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Lymph node under injection side armpit has been very swollen and moserately painful since yesterday.

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Lymph node under injection arm is still midly swolen and sore

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good

Free text: Lymph node under injection side armpit still swollen, mildly sore, but getting better.

MedDRA releases: 2024-11 · check-in free text available
2021-09-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-02
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-09
Survey response — day 14, dose 3
MedDRA: Pre-existing disease, Superficial vein thrombosis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I have a 15cm long blood clot in a superficial vein in my right calf. I'm reporting it just in case it's related to the vaccine, but I had a similar blood clot in my genital area 21 years ago when I was 17, so it's probably not due to the vaccine.

MedDRA releases: 2024-11 · check-in free text available
2021-10-09
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-29
Survey response — day 35, dose 3
MedDRA: Headache — Feeling: Fair

Free text: Headache

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Call 1 — Left Voicemail
2021-11-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-25
Survey response — 6 months, dose 3
MedDRA: Superficial vein thrombosis — Feeling: Good

Free text: Another superficial thrombophlebitis, this time in my arm.

MedDRA releases: 2024-11 · check-in free text available
2022-09-25
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2022-10-17
Dose 4 — Moderna
2022-10-17
Survey response — day 0, dose 4
MedDRA: Headache — Feeling: Fair · Headache

Free text: I get chronic headaches, may be coincidental.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Pfizer-BioNTech
2	2021-02-16	Pfizer-BioNTech
3	2021-09-24	Pfizer-BioNTech	Flu
4	2022-10-17	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 3 — day 7, dose 1

2021-02-04

Systemic reaction (other): I get chronic headaches, so probably not related to vaccine.

Release 9 — days 1–6 daily, dose 3

2021-09-25

Systemic reaction (other): Mildly to moderately elevated blood pressure and heart rate that felt like palpitations (but wasn't)

Release 9 — day 0, dose 3

2021-09-25

Systemic reaction (other): Heart palpitations, light headed starting 5 minutes after jab, lasting 4 hours.

Release 9 — days 1–6 daily, dose 3

2021-09-27

Systemic reaction (other): Lymph node under injection side armpit has been very swollen and moserately painful since yesterday.

2021-09-28

Systemic reaction (other): Lymph node under injection arm is still midly swolen and sore

2021-09-29

Systemic reaction (other): Lymph node under injection side armpit still swollen, mildly sore, but getting better.

Release 10 — day 14, dose 3

2021-10-09

Symptoms: I have a 15cm long blood clot in a superficial vein in my right calf. I'm reporting it just in case it's related to the vaccine, but I had a similar blood clot in my genital area 21 years ago when I was 17, so it's probably not due to the vaccine.

Release 10 — day 35, dose 3

2021-10-29

Symptoms: Headache

Release 11 — 6 months, dose 3

2022-03-25

Symptoms: Another superficial thrombophlebitis, this time in my arm.

Release 12 — day 0, dose 4

2022-10-17

Systemic reaction (other): I get chronic headaches, may be coincidental.

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	Headache	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Superficial vein thrombosis	·	·	✓
SRO	Blood pressure increased	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Headache	○	✓	✓
SRO	Heart rate increased	·	·	✓
SRO	Immediate post-injection reaction	·	·	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Palpitations	·	·	✓
SRO	Pre-existing disease	✓	·	✓

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