XZN-50668-66588

2 vaccinations 14 coded responses 21 check-ins 14 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 545 / WI
Registered: 2021-02-28

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

2021-02-26
Dose 1 — Pfizer-BioNTech
2021-02-28
Registered in v-safe
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Fair · Be unable to do your normal daily activities

Free text: Coughing...not the usual allergy cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Office visit, SARS-CoV-2 test — Feeling: Fair · Chills · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Went to Urgent Care to have a Dr listen to my lungs. Also, had a covid test.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Croup infectious, SARS-CoV-2 test negative — Feeling: Fair · Chills

Free text: Still has the barky cough...Covid test was negative!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — day 7, dose 1
MedDRA: Cough — Feeling: Good

Free text: Still has the cough, but not as bad.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 14, dose 1
MedDRA: Cough, Decreased appetite, Office visit, SARS-CoV-2 test negative, Somnolence — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Coughing isn't going away. Some loss of appetite. Sleeping a lot. Worried about him getting dehydrated. Urgent care visit on the 4th. Dr. didn't hear anything in his lungs. Could these symptoms be from the vaccine?? · Healthcare visit (other): Covid test was negative

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Dose 2 — Pfizer-BioNTech
2021-03-19
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Fair · Site: Swelling · Chills, Muscle or body aches

Free text: Small bruise at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Good

Free text: Coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Fatigue or tiredness

Free text: Continued coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Good · Fatigue or tiredness

Free text: Continued coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Coughing continues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — day 7, dose 2
MedDRA: Cough — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Persistant coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 14, dose 2
MedDRA: Surgery — Feeling: Poor · Be unable to do your normal daily activities

Free text: He is in surgery now for a chest tube insertion!!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 21, dose 2
MedDRA: Emergency care, Fall, Hospitalisation — Feeling: Fair · Be unable to do your normal daily activities

Free text: Bad fall...went to ER, then admitted to hospital...transferred to (b)(6) on Easter Day...to MICU!! Still in hospital!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — day 28, dose 2
MedDRA: Atrial fibrillation, Fall, Head injury, Neck injury — Feeling: Fair · Be unable to do your normal daily activities

Free text: In rehab after fall. Injuries to head & neck. A fib, plural fluid still draining.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-04
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Pfizer-BioNTech
2	2021-03-19	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-03-03	Unsuccessful
2021-03-12	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-03-02

Systemic reaction (other): Coughing...not the usual allergy cough.

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): Went to Urgent Care to have a Dr listen to my lungs. Also, had a covid test.

2021-03-04

Systemic reaction (other): Still has the barky cough...Covid test was negative!

Release 5 — day 7, dose 1

2021-03-05

Systemic reaction (other): Still has the cough, but not as bad.

Release 5 — day 14, dose 1

2021-03-12

Symptoms: Coughing isn't going away. Some loss of appetite. Sleeping a lot. Worried about him getting dehydrated. Urgent care visit on the 4th. Dr. didn't hear anything in his lungs. Could these symptoms be from the vaccine??

Healthcare visit (other): Covid test was negative

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Small bruise at injection site

2021-03-21

Systemic reaction (other): Coughing

2021-03-23

Systemic reaction (other): Continued coughing

2021-03-24

Systemic reaction (other): Continued coughing

2021-03-25

Systemic reaction (other): Coughing continues

Release 6 — day 7, dose 2

2021-03-26

Systemic reaction (other): Persistant coughing

Release 6 — day 14, dose 2

2021-04-02

Symptoms: He is in surgery now for a chest tube insertion!!

Release 7 — day 21, dose 2

2021-04-09

Symptoms: Bad fall...went to ER, then admitted to hospital...transferred to (b)(6) on Easter Day...to MICU!! Still in hospital!

redacted (b)(6)

Release 7 — day 28, dose 2

2021-04-18

Symptoms: In rehab after fall. Injuries to head & neck. A fib, plural fluid still draining.

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	SARS-CoV-2 test negative	✓	✓	✓
SD	Atrial fibrillation	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Fall	✓	✓	✓
SD	Head injury	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Neck injury	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Surgery	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Croup infectious	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Office visit	✓	✓	✓
SRO	SARS-CoV-2 test	✓	✓	✓
SRO	SARS-CoV-2 test negative	✓	✓	✓

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