XG5-28617-20454

4 vaccinations 10 coded responses 34 check-ins 9 free-text entries 5 call cases

Sex: Male
Age at first dose: 36-40
ZIP prefix: 940 / CA
Registered: 2021-02-25

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

Registered dependents

VVA-36795-91095 Child or adolescent in my care · Female · 2022-06-24

4AK-17237-20552 Child or adolescent in my care · Male · 2022-06-24

Timeline

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

2021-02-25
Registered in v-safe
2021-02-25
Dose 1 — Pfizer-BioNTech
2021-02-25
Health check-in — day 0, dose 1
Feeling: Fair · Muscle or body aches, Abdominal pain

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-11
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-18
Survey response — day 21, dose 1
MedDRA: Dental discomfort, Headache — Feeling: Fair

Free text: Headaches, tooth discomfort.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Dose 2 — Pfizer-BioNTech
2021-03-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — day 7, dose 2
Feeling: Poor · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-08
Survey response — day 14, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-22
Survey response — day 28, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I had an egg retrieval for IVF.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 28, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-24
Survey response — 3 months, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Health issues associated with medical treatment.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-28
Call 1 — Left Voicemail
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Pregnancy — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Im pregnant.

MedDRA releases: 2024-11 · check-in free text available
2021-09-23
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-09-27
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-13
Dose 3 — Pfizer-BioNTech
2022-03-25
Survey response — 12 months, dose 2
MedDRA: Pregnancy — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Late pregnancy. · Healthcare visit (other): I'm doing pregnancy checkups.

MedDRA releases: 2024-11 · check-in free text available
2022-03-25
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-28
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-20
Survey response — 6 months, dose 3
MedDRA: Blood pressure increased, Delivery — Feeling: Fair · 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 consultation, Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: I gave birth to a baby. It was pretty tiring. My blood pressure increased due to pregnancy.

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2022-04-28
Call 1 — Left Voicemail
2022-09-06
Dose 4 — Pfizer-BioNTech
2022-09-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-09-27
Survey response — day 21, dose 4
MedDRA: Headache, Malaise, Nausea, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: I got a flu shot yesterday and feel like garbage today, body aches, nausea, headaches.

MedDRA releases: 2024-11 · check-in free text available
2022-10-04
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-11
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-18
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-06
Survey response — 3 months, dose 4
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good

Free text: I've had several colds, because my kids are in daycare. Nothing severe, all my COVID tests have been negative.

MedDRA releases: 2024-11 · check-in free text available
2023-03-07
Survey response — 6 months, dose 4
MedDRA: Nasopharyngitis — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Pfizer-BioNTech
2	2021-03-25	Pfizer-BioNTech
3	2021-10-13	Pfizer-BioNTech	No
4	2022-09-06	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-22	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-24	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-23	Successful 2021-09-27	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-25	Successful 2022-03-28	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-20	Unsuccessful

Free text

Release 5 — day 21, dose 1

2021-03-18

Symptoms: Headaches, tooth discomfort.

Release 7 — day 14, dose 2

2021-04-08

Symptoms: Fatigue

Release 7 — day 28, dose 2

2021-04-22

Symptoms: I had an egg retrieval for IVF.

Release 9 — 3 months, dose 2

2021-06-24

Symptoms: Health issues associated with medical treatment.

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: Im pregnant.

Release 11 — 12 months, dose 2

2022-03-25

Symptoms: Late pregnancy.

Healthcare visit (other): I'm doing pregnancy checkups.

Release 11 — 6 months, dose 3

2022-04-20

Symptoms: I gave birth to a baby. It was pretty tiring. My blood pressure increased due to pregnancy.

Release 12 — day 21, dose 4

2022-09-27

Symptoms: I got a flu shot yesterday and feel like garbage today, body aches, nausea, headaches.

Release 12 — 3 months, dose 4

2022-12-06

Symptoms: I've had several colds, because my kids are in daycare. Nothing severe, all my COVID tests have been negative.

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	Pregnancy	·	·	✓
SD	Adverse reaction	✓	✓	✓
SD	Blood pressure increased	·	·	✓
SD	Delivery	·	·	✓
SD	Dental discomfort	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Malaise	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Pregnancy	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Unevaluable event	✓	✓	✓

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