U5H-21137-90985
4 vaccinations
3 coded responses
38 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 31-35
- ZIP prefix
- 430 / OH
- Registered
- 2021-03-23
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Hispanic or Latino
Registered dependents
ZJ3-67469-03986
Child or adolescent in my care · Male · 2022-07-13
XFC-29792-37623
Child or adolescent in my care · Female · 2022-09-16
Timeline
-
2021-03-23
Registered in v-safe
-
2021-03-23
Dose 1 — Pfizer-BioNTech
- 2021-03-23
-
2021-03-24
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-04-06
-
2021-04-13
Dose 2 — Pfizer-BioNTech
- 2021-04-13
-
2021-04-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Night sweats — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Night sweatsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-22
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-05-25
- 2021-07-13
- 2021-10-12
-
2021-12-08
Dose 3 — Pfizer-BioNTech
- 2022-04-13
-
2022-09-30
Dose 4 — Moderna
-
2022-10-02
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-03
- 2022-10-04
- 2022-10-05
- 2022-10-06
- 2022-10-07
-
2022-10-16
Survey response — day 14, dose 4MedDRA: Respiratory symptom, SARS-CoV-2 test negative — Feeling: GoodFree text: Upper respiratory symptoms but have at home ag-tested 4x over the course of a week with all negative for COVID resultsMedDRA releases: 2024-11 · check-in free text available
- 2022-10-21
- 2022-10-28
- 2022-11-06
- 2022-11-11
- 2022-12-30
-
2023-03-31
Survey response — 6 months, dose 4MedDRA: Cough, Fatigue, Pyrexia, Respiratory tract congestion — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
-
2023-03-31
Report sent to call center — 6 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2023-04-03
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-23 | Pfizer-BioNTech | |
| 2 | 2021-04-13 | Pfizer-BioNTech | |
| 3 | 2021-12-08 | Pfizer-BioNTech | No |
| 4 | 2022-09-30 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-03-31 | Successful 2023-04-03 |
Completed over the phone |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Night sweats
Release 12 — day 14, dose 4
Symptoms: Upper respiratory symptoms but have at home ag-tested 4x over the course of a week with all negative for COVID results
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 | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory symptom | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release