ZFK-10540-21792

3 vaccinations 16 coded responses 27 check-ins 16 free-text entries 12 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 292 / SC
Registered: 2021-01-29

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-27
Dose 1 — Pfizer-BioNTech
2021-01-29
Registered in v-safe
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Urinary tract infection — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-03
Survey response — day 7, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: PARKINSONS

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 14, dose 1
MedDRA: Arthralgia, Office visit, Pain, Pain in extremity, Pre-existing disease, Urinary tract infection — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Serious UTI and body aches and joint pains. Other than new leg pains. We assume these symptoms are from pre-existing condition. · Healthcare visit (other): Infectious Disease specialist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-17
Dose 2 — Pfizer-BioNTech
2021-02-17
Survey response — day 0, dose 2
MedDRA: Medical counselling, Nephrolithiasis, Renal pain, Urinary tract infection — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): I have a UTI causing me to pass small kidney stones and blood. · Healthcare visit (other): Urologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Report sent to call center — day 0, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Urinary tract infection — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Serious fatigue and UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-21
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
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Chromaturia, Emergency care — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Dark Brown discharge in urine. Thought it was blood. In the ER.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Chromaturia — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Dark reddish black looking urine. Is that a side effect.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-24
Survey response — day 7, dose 2
MedDRA: Urinary tract infection — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Urine cleared up . I have a UTI and other issues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — day 14, dose 2
MedDRA: Hospitalisation, Urinary tract infection — Feeling: Poor · Get care from a doctor or other healthcare professional · Hospitalization

Free text: UTI worsened. In hospital.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Survey response — day 21, dose 2
MedDRA: Hospitalisation, Urinary tract infection — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: In the hospital with UTI and recovering.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-17
Survey response — day 28, dose 2
MedDRA: Myalgia, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Muscular pains in my thighs and legs. · Healthcare visit (other): doctors appointment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-31
Survey response — day 42, dose 2
MedDRA: Pain in extremity — Feeling: Fair · 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

Free text: Leg pains

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
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)
2021-05-19
Survey response — 3 months, dose 2
MedDRA: Pain in extremity, Parkinson's disease, Pre-existing disease, Urinary tract infection — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Achy legs and UTI and increased Parkinsons symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-14
Call successful
Does not wish to fill out VAERS report
2021-08-18
Survey response — 6 months, dose 2
MedDRA: Sepsis — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Sepsis

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-18
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-20
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-24
Dose 3 — Pfizer-BioNTech
2021-10-03
Survey response — day 7, dose 3
MedDRA: Cough — Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: cough

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-10-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-31
Survey response — day 35, dose 3
MedDRA: Blood pressure abnormal — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Blood pressure unsteady.

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
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

Emergency room or emergency department visit · 1 call case(s)
2021-11-03
Call 1 — Left Voicemail
2021-12-28
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-03-28
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Pfizer-BioNTech
2	2021-02-17	Pfizer-BioNTech
3	2021-09-24	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-10	Successful	Does not wish to fill out VAERS report
2021-02-17	Successful	Does not wish to fill out VAERS report
2021-02-20	Successful	Does not wish to fill out VAERS report
2021-02-22	Successful	Does not wish to fill out VAERS report
2021-02-23	Successful	Does not wish to fill out VAERS report
2021-03-03	Successful	Does not wish to fill out VAERS report
2021-03-10	Successful	Does not wish to fill out VAERS report
2021-03-17	Successful	Does not wish to fill out VAERS report
2021-03-31	Successful	Does not wish to fill out VAERS report
2021-05-19	Successful 2021-06-14	Does not wish to fill out VAERS report
2021-08-18	Successful 2021-08-20	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-31	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-31

Systemic reaction (other): UTI

Release 3 — day 7, dose 1

2021-02-03

Systemic reaction (other): PARKINSONS

Release 4 — day 14, dose 1

2021-02-10

Symptoms: Serious UTI and body aches and joint pains. Other than new leg pains. We assume these symptoms are from pre-existing condition.

Healthcare visit (other): Infectious Disease specialist

Release 4 — day 0, dose 2

2021-02-17

Systemic reaction (other): I have a UTI causing me to pass small kidney stones and blood.

Healthcare visit (other): Urologist

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): Serious fatigue and UTI

2021-02-22

Systemic reaction (other): Dark Brown discharge in urine. Thought it was blood. In the ER.

2021-02-23

Systemic reaction (other): Dark reddish black looking urine. Is that a side effect.

Release 4 — day 7, dose 2

2021-02-24

Systemic reaction (other): Urine cleared up . I have a UTI and other issues.

Release 5 — day 14, dose 2

2021-03-03

Symptoms: UTI worsened. In hospital.

Release 5 — day 21, dose 2

2021-03-10

Symptoms: In the hospital with UTI and recovering.

Release 5 — day 28, dose 2

2021-03-17

Symptoms: Muscular pains in my thighs and legs.

Healthcare visit (other): doctors appointment

Release 6 — day 42, dose 2

2021-03-31

Symptoms: Leg pains

Release 8 — 3 months, dose 2

2021-05-19

Symptoms: Achy legs and UTI and increased Parkinsons symptoms

Release 9 — 6 months, dose 2

2021-08-18

Symptoms: Sepsis

Release 9 — day 7, dose 3

2021-10-03

Systemic reaction (other): cough

Release 10 — day 35, dose 3

2021-10-31

Symptoms: Blood pressure unsteady.

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	Arthralgia	✓	✓	✓
SD	Blood pressure abnormal	·	·	✓
SD	Hospitalisation	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Parkinson's disease	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sepsis	✓	·	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Chromaturia	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Emergency care	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Nephrolithiasis	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Renal pain	✓	✓	✓
SRO	Urinary tract infection	✓	✓	✓

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