6YG-16173-48418

3 vaccinations 11 coded responses 16 check-ins 11 free-text entries 5 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 394 / MS
Registered: 2021-04-10

Relationship: Self
Race: Black or African American
Ethnicity: N/A

Timeline

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

2021-04-02
Dose 1 — Pfizer-BioNTech
2021-04-10
Registered in v-safe
2021-04-10
Survey response — day 7, dose 1
MedDRA: Asthenia, Chest pain, Dizziness, Dyspepsia — Feeling: Poor · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Weak light headed heartburn or chest pains

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 14, dose 1
MedDRA: Abdominal pain upper, Fatigue, Nervousness, Office visit, Sleep disorder — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Stomach pain in gas all day every day.bad nerves afraid to fall asleep..worried.... feeling over fatigue past 14 days have to over eat and over drink reduce stomach pain .. went to dr. Last week not feeling my self · Healthcare visit (other): My Dr.office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-23
Dose 2 — Pfizer-BioNTech
2021-04-23
Survey response — day 0, dose 2
MedDRA: Eye irritation — Feeling: Fair

Free text: Eyes and guns burniny

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: Responding well to second dose I feel better with it than without it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I think everything my be from my job

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — day 7, dose 2
MedDRA: Abdominal pain — Feeling: Good · Abdominal pain

Free text: If feel better today just some abdominal pain mild my be my diet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — day 14, dose 2
MedDRA: Dyspnoea, Fatigue, Insomnia — Feeling: Fair

Free text: Cant sleep worried feels like its harder to breath I dont know if Im just tired from work and this mask or what no fever just worried more than anything

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — day 35, dose 2
MedDRA: Hypertension — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: High blood pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-04
Survey response — day 42, dose 2
MedDRA: Dyspnoea, Hypertension, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Blood pressure too high hard to breath · Healthcare visit (other): Twice

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-23
Survey response — 3 months, dose 2
MedDRA: Chromaturia, Dyspepsia, Office visit, Renal pain — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Dark pee heart burn feeling. Kidney pain daily · Healthcare visit (other): Mr dr

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-23
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-26
Call 1 — Left Voicemail
2021-10-22
Survey response — 6 months, dose 2
MedDRA: Abdominal pain upper — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Stomach pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-22
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-23
Dose 3 — Pfizer-BioNTech
2021-10-27
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-02	Pfizer-BioNTech
2	2021-04-23	Pfizer-BioNTech
3	2021-10-23	Pfizer-BioNTech	No

Call center

5 call center cases

5 unsuccessful

See the call center timeline

Free text

Release 7 — day 7, dose 1

2021-04-10

Systemic reaction (other): Weak light headed heartburn or chest pains

Release 7 — day 14, dose 1

2021-04-16

Symptoms: Stomach pain in gas all day every day.bad nerves afraid to fall asleep..worried.... feeling over fatigue past 14 days have to over eat and over drink reduce stomach pain .. went to dr. Last week not feeling my self

Healthcare visit (other): My Dr.office

Release 7 — day 0, dose 2

2021-04-23

Systemic reaction (other): Eyes and guns burniny

Release 8 — days 1–6 daily, dose 2

2021-04-28

Systemic reaction (other): Responding well to second dose I feel better with it than without it.

2021-04-29

Systemic reaction (other): I think everything my be from my job

Release 8 — day 7, dose 2

2021-04-30

Systemic reaction (other): If feel better today just some abdominal pain mild my be my diet

Release 8 — day 14, dose 2

2021-05-09

Symptoms: Cant sleep worried feels like its harder to breath I dont know if Im just tired from work and this mask or what no fever just worried more than anything

Release 8 — day 35, dose 2

2021-05-28

Symptoms: High blood pressure

Release 8 — day 42, dose 2

2021-06-04

Symptoms: Blood pressure too high hard to breath

Healthcare visit (other): Twice

Release 9 — 3 months, dose 2

2021-07-23

Symptoms: Dark pee heart burn feeling. Kidney pain daily

Healthcare visit (other): Mr dr

Release 10 — 6 months, dose 2

2021-10-22

Symptoms: Stomach 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	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Chromaturia	✓	·	✓
SD	Dyspepsia	✓	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Nervousness	✓	✓	✓
SD	Renal pain	✓	·	✓
SD	Sleep disorder	✓	✓	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Eye irritation	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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