ZFM-28061-58246

5 vaccinations 16 coded responses 45 check-ins 14 free-text entries 0 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 752 / TX
Registered: 2021-03-18

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-18
Registered in v-safe
2021-03-18
Dose 1 — Pfizer-BioNTech
2021-03-18
Survey response — day 0, dose 1
MedDRA: Hypoaesthesia — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: numbness in neck and side of head above injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia — Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Free text: numbness still on left side of face

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia — Feeling: Good · Fever

Free text: numbness still left side of head

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Survey response — day 7, dose 1
MedDRA: Tinnitus — Feeling: Good

Free text: ringing in the ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-14
Dose 2 — Pfizer-BioNTech
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: numbness on left side of head

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia — Feeling: Good · Site: Pain

Free text: numbness on left cheek

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia — Feeling: Good

Free text: numbness on left side of face and head

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-10-14
Survey response — 6 months, dose 2
MedDRA: Oropharyngeal pain, Pre-existing disease — Feeling: Fair

Free text: Sore throat consistent with allergies

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Dose 3 — Moderna
2021-11-15
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-11-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-11-17
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Survey response — days 1–6 daily, dose 3
MedDRA: Throat irritation, Upper-airway cough syndrome — Feeling: Fair

Free text: Scratchy throat, post nasal drip

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Survey response — days 1–6 daily, dose 3
MedDRA: Throat irritation — Feeling: Fair · Fatigue or tiredness

Free text: Scratchy throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-11-21
Survey response — days 1–6 daily, dose 3
MedDRA: Throat irritation — Feeling: Fair · Fatigue or tiredness

Free text: Scratchy throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-29
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-20
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-14
Survey response — 3 months, dose 3
MedDRA: Upper-airway cough syndrome — Feeling: Fair · Be unable to do your normal daily activities

Free text: Persistent postnasal drip

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Dose 4 — Moderna
2022-05-19
Survey response — day 0, dose 4
MedDRA: Hypoaesthesia, Injection site hypoaesthesia — Feeling: Good · Site: Pain, Itching

Free text: From injection site up my neck towards ear: some numbness

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Itching · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2022-05-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-05-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-05-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-26
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-02
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-16
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-23
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-29
Dose 5 — Moderna
2022-10-22
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-03
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-10
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-01
Survey response — 3 months, dose 5
MedDRA: Nausea — Feeling: Fair

MedDRA releases: 2024-11
2023-03-30
Survey response — 6 months, dose 5
MedDRA: Prostatomegaly, Urinary retention, Vitreous floaters — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Pfizer-BioNTech
2	2021-04-14	Pfizer-BioNTech
3	2021-11-15	Moderna	No
4	2022-05-19	Moderna	No
5	2022-09-29	Moderna	No

Free text

Release 5 — day 0, dose 1

2021-03-18

Systemic reaction (other): numbness in neck and side of head above injection site

Release 5 — days 1–6 daily, dose 1

2021-03-19

Systemic reaction (other): numbness still on left side of face

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): numbness still left side of head

Release 6 — day 7, dose 1

2021-03-25

Systemic reaction (other): ringing in the ears

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): numbness on left side of head

2021-04-16

Systemic reaction (other): numbness on left cheek

2021-04-17

Systemic reaction (other): numbness on left side of face and head

Release 10 — 6 months, dose 2

2021-10-14

Symptoms: Sore throat consistent with allergies

Release 10 — days 1–6 daily, dose 3

2021-11-17

Systemic reaction (other): Sore throat

2021-11-18

Systemic reaction (other): Scratchy throat, post nasal drip

2021-11-19

Systemic reaction (other): Scratchy throat

2021-11-21

Systemic reaction (other): Scratchy throat

Release 11 — 3 months, dose 3

2022-02-14

Symptoms: Persistent postnasal drip

Release 11 — day 0, dose 4

2022-05-19

Systemic reaction (other): From injection site up my neck towards ear: some numbness

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
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Prostatomegaly	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SD	Urinary retention	·	·	✓
SD	Vitreous floaters	·	·	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Injection site hypoaesthesia	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Throat irritation	·	·	✓
SRO	Tinnitus	✓	✓	✓
SRO	Upper-airway cough syndrome	·	·	✓

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