XWA-96977-36707

6 vaccinations 11 coded responses 30 check-ins 9 free-text entries 2 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 914 / CA
Registered: 2021-04-06

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

Timeline

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

2021-03-15
Dose 1 — Pfizer-BioNTech
2021-04-05
Dose 2 — Pfizer-BioNTech
2021-04-06
Registered in v-safe
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Fatigue — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Vertigo — Feeling: Poor · Fever · Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — 7 day, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-19
Survey response — 14 day, dose 2
MedDRA: Dizziness, Vertigo — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-26
Health check-in — 21 day, dose 2
Feeling: Fair

Adult check-in
2021-05-03
Survey response — 28 day, dose 2
MedDRA: Dizziness, Nausea, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-03
Report sent to call center — 28 day, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-10
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-07-05
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-10-04
Dose 3 — Pfizer-BioNTech
2021-10-04
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2021-10-06
Survey response — days 1–6 daily, dose 3
MedDRA: Radiotherapy — Feeling: Poor · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-11
Survey response — 7 day, dose 3
MedDRA: Sinus congestion — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-10-18
Survey response — 14 day, dose 3
MedDRA: Cough, Sinus congestion — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2021-10-25
Health check-in — 21 day, dose 3
Feeling: Fair

Adult check-in
2021-11-01
Health check-in — 28 day, dose 3
Feeling: Fair

Adult check-in
2021-11-10
Health check-in — 35 day, dose 3
Feeling: Fair

Adult check-in
2021-11-15
Health check-in — 42 day, dose 3
Feeling: Fair

Adult check-in
2022-01-03
Survey response — 3 month, dose 3
MedDRA: Cough, Fatigue, Pulmonary congestion, Sinus congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-02-25
Dose 4 — Moderna
2022-04-04
Health check-in — 6 month, dose 3
Feeling: Poor

Adult check-in
2022-04-14
Health check-in — 42 day, dose 4
Feeling: Fair

Adult check-in
2022-04-19
Call 3 — Left Voicemail
2022-05-27
Health check-in — 3 month, dose 4
Feeling: Fair

Adult check-in
2022-07-24
Dose 5 — Moderna
Co-administered: Pneumonia
2022-08-26
Health check-in — 6 month, dose 4
Feeling: Fair

Adult check-in
2022-11-17
Dose 6 — Moderna
2023-02-27
Survey response — 12 month, dose 4
MedDRA: COVID-19, Intervertebral disc protrusion, Nerve compression — 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

MedDRA releases: 2024-11 · check-in answers available
2023-02-27
Report sent to call center — 12 month, dose 4
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 · 1 call case(s)
2023-02-28
Call 1 — Could Not Reach Participant
2023-02-28
Call 1 — Could Not Reach Participant
2023-03-03
Call 2 — Could Not Reach Participant
2023-03-03
Call 2 — Could Not Reach Participant
2023-05-18
Survey response — 6 month, dose 6
MedDRA: Fatigue — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Pfizer-BioNTech
2	2021-04-05	Pfizer-BioNTech
3	2021-10-04	Pfizer-BioNTech	No
4	2022-02-25	Moderna	No
5	2022-07-24	Moderna	Pneumonia
6	2022-11-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-03	Unsuccessful
2023-02-27	Unsuccessful

Free text

Release 7

Systemic reaction (other): When I got the first dose on April 5, I was fatigued for 4 days but most troubling was lightheaded for more than two weeks. Sometime I would almost pass out

Systemic reaction (other): Light-headed at times

Systemic reaction (other): Vertigo

Symptoms: Occasional light-headedness and sometimes vertigo

Release 8

Symptoms: Lightheadedness, causing nausea and need to immediately sit or lay down

Healthcare visit (other): Visited my internist

Release 10

Systemic reaction (other): 2 days finished 2 months of prostate cancer radiation therapy

Systemic reaction (other): Sinus congestion

Symptoms: Heavy sinus congestion and slight cough

Symptoms: Congestion in lungs; cough; sinus congestion; fatigue

Free-text releases are not linked to a specific 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	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Intervertebral disc protrusion	·	·	✓
SD	Nausea	✓	✓	✓
SD	Nerve compression	·	·	✓
SD	Pulmonary congestion	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Vertigo	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Radiotherapy	·	·	✓
SRO	Sinus congestion	·	·	✓
SRO	Vertigo	✓	✓	✓

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