Z9J-12316-55238

3 vaccinations 12 coded responses 19 check-ins 12 free-text entries 5 call cases

Sex: —
Age at first dose: 66+
ZIP prefix: 666 / KS
Registered: 2021-02-16

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

Timeline

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

2021-02-12
Dose 1 — Pfizer-BioNTech
2021-02-16
Registered in v-safe
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Sneezing — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sneezing & cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain, Sinus disorder — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sinuses, sore throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — day 7, dose 1
MedDRA: Ear discomfort, Sinus disorder — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sinuses, ears clogged.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-05
Dose 2 — Pfizer-BioNTech
2021-03-05
Health check-in — day 0, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Paraesthesia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tingling neck n shoulder

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Paraesthesia — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Tingling back of left ear down neck.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 21, dose 2
MedDRA: Cough, Dyspnoea, Fatigue, Medical counselling, Respiratory tract congestion — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Cough, chest congestion, shortness of breath, fatigue. · Healthcare visit (other): Made appointment to see MD.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-03
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-09
Survey response — day 35, dose 2
MedDRA: Arthralgia, Fatigue, Irritability, Mass, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Annual checkup, xray 12mm mass in one lung; ct scan today confirms so new test with dye soon. Fatigue. Joint pains. Grumpy. · Healthcare visit (other): CT scan of lungs.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-16
Survey response — day 42, dose 2
MedDRA: Positron emission tomogram, Pulmonary mass, Unevaluable event — Feeling: Fair · 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: Symptoms: Nodule discoveted in lung. · Healthcare visit (other): Petscan

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-04
Survey response — 3 months, dose 2
MedDRA: Cough, Dyspnoea, Headache, Limb discomfort, Office visit, Productive cough — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Heavy legs. Shortness of breath. Headaches. Coughing flem. · Healthcare visit (other): MD visit n referal for xray, cstscan et al.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
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)
2021-09-03
Survey response — 6 months, dose 2
MedDRA: Back disorder, Pulmonary congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Clogged lungs. Back problems. P

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-21
Dose 3 — Pfizer-BioNTech
2021-12-10
Call 1 — Left Voicemail
2022-03-06
Survey response — 12 months, dose 2
MedDRA: Cough, Fatigue, Myalgia, Pain in extremity, Respiratory tract congestion, Sinus congestion — Feeling: Poor · Be unable to do your normal daily activities

Free text: Cough, cogestion, sinus clogged, muscle aches, big toe and foot pain. Chronic tired.

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Survey response — 6 months, dose 3
MedDRA: Cough, Dry skin, Ear discomfort, Muscle spasms, Neuropathy peripheral, Pruritus, Respiratory tract congestion, Sinus congestion — Feeling: Poor · 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: Chest congestion, cough, sinuses clogged. Ears jammed, feet andleg cramps, dry itchy skin, neuropathy, dry scalp.

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-26
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Pfizer-BioNTech
2	2021-03-05	Pfizer-BioNTech
3	2021-10-21	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-26	Unsuccessful
2021-04-09	Unsuccessful
2021-04-16	Unsuccessful
2021-06-04	Unsuccessful
2022-04-22	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-17

Systemic reaction (other): Sneezing & cough.

2021-02-18

Systemic reaction (other): Sinuses, sore throat.

Release 4 — day 7, dose 1

2021-02-19

Systemic reaction (other): Sinuses, ears clogged.

Release 5 — days 1–6 daily, dose 2

2021-03-09

Systemic reaction (other): Tingling neck n shoulder

2021-03-11

Systemic reaction (other): Tingling back of left ear down neck.

Release 6 — day 21, dose 2

2021-03-26

Symptoms: Cough, chest congestion, shortness of breath, fatigue.

Healthcare visit (other): Made appointment to see MD.

Release 7 — day 35, dose 2

2021-04-09

Symptoms: Annual checkup, xray 12mm mass in one lung; ct scan today confirms so new test with dye soon. Fatigue. Joint pains. Grumpy.

Healthcare visit (other): CT scan of lungs.

Release 7 — day 42, dose 2

2021-04-16

Symptoms: Nodule discoveted in lung.

Healthcare visit (other): Petscan

Release 8 — 3 months, dose 2

2021-06-04

Symptoms: Heavy legs. Shortness of breath. Headaches. Coughing flem.

Healthcare visit (other): MD visit n referal for xray, cstscan et al.

Release 9 — 6 months, dose 2

2021-09-03

Symptoms: Clogged lungs. Back problems. P

Release 11 — 12 months, dose 2

2022-03-06

Symptoms: Cough, cogestion, sinus clogged, muscle aches, big toe and foot pain. Chronic tired.

Release 11 — 6 months, dose 3

2022-04-22

Symptoms: Chest congestion, cough, sinuses clogged. Ears jammed, feet andleg cramps, dry itchy skin, neuropathy, dry scalp.

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	✓	✓	✓
HCVO	Positron emission tomogram	○	✓	○
HCVO	Unevaluable event	✓	·	✓
SD	Arthralgia	✓	✓	✓
SD	Back disorder	✓	·	✓
SD	Cough	✓	✓	✓
SD	Dry skin	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Ear discomfort	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Irritability	✓	✓	✓
SD	Limb discomfort	✓	✓	✓
SD	Mass	✓	✓	✓
SD	Muscle spasms	·	·	✓
SD	Myalgia	·	·	✓
SD	Neuropathy peripheral	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Productive cough	✓	✓	✓
SD	Pruritus	·	·	✓
SD	Pulmonary congestion	✓	·	✓
SD	Pulmonary mass	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sinus congestion	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓
SRO	Sneezing	✓	✓	✓

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