XWT-21318-26801

4 vaccinations 6 coded responses 34 check-ins 5 free-text entries 2 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 972 / OR
Registered: 2021-04-13

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

2021-04-12
Dose 1 — Pfizer-BioNTech
2021-04-13
Registered in v-safe
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Headache

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-19
Survey response — 7 day, dose 1
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-26
Health check-in — 14 day, dose 1
Feeling: Fair

Adult check-in
2021-05-03
Dose 2 — Pfizer-BioNTech
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle twitching — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-10
Health check-in — 7 day, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-05-17
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — 28 day, dose 2
Feeling: Fair

Adult check-in
2021-06-07
Survey response — 35 day, dose 2
MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-14
Health check-in — 42 day, dose 2
Feeling: Fair

Adult check-in
2021-08-02
Health check-in — 3 month, dose 2
Feeling: Fair

Adult check-in
2021-11-01
Survey response — 6 month, dose 2
MedDRA: Musculoskeletal stiffness, Office visit, Pain in extremity, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2021-11-01
Report sent to call center — 6 month, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-02
Call successful
Does not wish to fill out VAERS report
2022-01-03
Dose 3 — Pfizer-BioNTech
2022-05-03
Health check-in — 12 month, dose 2
Feeling: Good

Adult check-in
2022-07-04
Survey response — 6 month, dose 3
MedDRA: Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2022-07-04
Report sent to call center — 6 month, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-05
Call 1 — Left Voicemail
2022-07-05
Call 1 — Left Voicemail
2023-01-03
Health check-in — 12 month, dose 3
Feeling: Fair

Adult check-in
2023-02-18
Dose 4 — Pfizer-BioNTech
2023-02-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Nausea, Diarrhea, Abdominal pain

Adult check-in
2023-02-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2023-02-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2023-02-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2023-02-28
Health check-in — 7 day, dose 4
Feeling: Good · None

Adult check-in
2023-03-04
Health check-in — 14 day, dose 4
Feeling: Good

Adult check-in
2023-03-18
Health check-in — 28 day, dose 4
Feeling: Good

Adult check-in
2023-03-25
Health check-in — 35 day, dose 4
Feeling: Good

Adult check-in
2023-04-01
Health check-in — 42 day, dose 4
Feeling: Good

Adult check-in
2023-05-20
Survey response — 3 month, dose 4
MedDRA: Abdominal pain upper, Chest pain — Feeling: Poor · Be unable to do your normal daily activities

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-12	Pfizer-BioNTech
2	2021-05-03	Pfizer-BioNTech
3	2022-01-03	Pfizer-BioNTech	No
4	2023-02-18	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-01	Successful 2021-11-02	Does not wish to fill out VAERS report
2022-07-04	Unsuccessful

Free text

Release 7

Systemic reaction (other): Ive had a extremely sharp pain in my wrist that remained for several minutes then hours later same extreme pain in a finger in opposite hand. Both were pinpoint, I was resting both times.

Release 8

Systemic reaction (other): Muscle twitching in entire right outermost chest

Symptoms: Headaches in the right temple are sharp come & go quickly

Release 10

Symptoms: Having issues with my toe's & began about January 2020 when they were pink. Now they have continued stiff feelings & sometimes pain.

Healthcare visit (other): Orthopedic

Release 12

Symptoms: Sinus infection it's grayish and now taking antibiotics.

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	Abdominal pain upper	·	·	✓
SD	Chest pain	·	·	✓
SD	Headache	✓	✓	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Muscle twitching	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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