YG6-68012-36145

3 vaccinations 6 coded responses 25 check-ins 6 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 970 / OR
Registered: 2021-03-17

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

2021-03-03
Dose 1 — Pfizer-BioNTech
2021-03-17
Registered in v-safe
2021-03-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-24
Dose 2 — Pfizer-BioNTech
2021-03-24
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache · Be unable to work

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Headache, Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Foggy brain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Abdominal pain · Be unable to work

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 35, dose 2
Feeling: Good

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

Adult check-in
2021-06-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Dose 3 — Pfizer-BioNTech
2021-11-03
Survey response — day 7, dose 3
MedDRA: Dizziness — Feeling: Good · Headache

Free text: Light headedness

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Survey response — day 35, dose 3
MedDRA: Asthenia, Headache, Medical counselling, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: 3 days of sore throat, headache, and low energy but no fever. Seem to be ok now. · Healthcare visit (other): Phone call to advice nurse who said i need to wait 5 days to get an antegen test for the test to be accurate.

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-07
Call 2 — Could Not Reach Participant
2021-12-10
Call 3 — Could Not Reach Participant
2022-01-26
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-28
Survey response — 6 months, dose 3
MedDRA: Dyspnoea, Office visit, Pulmonary oedema, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fluid on the lungs and shortness of breath. Tested for Covid. Negative. · Healthcare visit (other): Visit with family doctor.

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-29
Call 1 — Left Voicemail
2022-10-28
Survey response — 12 months, dose 3
MedDRA: Discomfort, Dyspnoea, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Shortness of breath and discomfort when taking deep breaths. · Healthcare visit (other): Visit with pulmonary doctor.

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-31
Call 1 — Left Voicemail
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 1 — Left Voicemail
2022-11-04
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-04
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-04
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Pfizer-BioNTech
2	2021-03-24	Pfizer-BioNTech
3	2021-10-26	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-30	Successful 2022-11-04	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-28	Successful 2022-11-04	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-28	Successful 2022-11-04	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6 — day 0, dose 2

2021-03-24

Systemic reaction (other): Light headed

Release 6 — days 1–6 daily, dose 2

2021-03-26

Systemic reaction (other): Foggy brain

Release 10 — day 7, dose 3

2021-11-03

Systemic reaction (other): Light headedness

Release 10 — day 35, dose 3

2021-11-30

Symptoms: 3 days of sore throat, headache, and low energy but no fever. Seem to be ok now.

Healthcare visit (other): Phone call to advice nurse who said i need to wait 5 days to get an antegen test for the test to be accurate.

Release 11 — 6 months, dose 3

2022-04-28

Symptoms: Fluid on the lungs and shortness of breath. Tested for Covid. Negative.

Healthcare visit (other): Visit with family doctor.

Release 12 — 12 months, dose 3

2022-10-28

Symptoms: Shortness of breath and discomfort when taking deep breaths.

Healthcare visit (other): Visit with pulmonary doctor.

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	Medical counselling	·	·	✓
HCVO	Office visit	·	·	✓
SD	Asthenia	·	·	✓
SD	Discomfort	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Headache	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pulmonary oedema	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓

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