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ZJJ-30702-63861

5 vaccinations 8 coded responses 36 check-ins 7 free-text entries 3 call cases
Sex
Male
Age at first dose
51-55
ZIP prefix
441 / OH
Registered
2021-03-22
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-21
    Dose 1 — Pfizer-BioNTech
  2. 2021-03-22
    Registered in v-safe
  3. 2021-03-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  4. 2021-03-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-03-24
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  7. 2021-03-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-28
    Health check-in — day 7, dose 1
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  9. 2021-04-04
    Survey response — day 14, dose 1
    MedDRA: Headache, Malaise, Myalgia, Pyrexia — Feeling: Good
    Free text: In the 9 days following vaccine felt ill periodically: general malaise, sore muscles, headaches, may have had slight fever. These symptoms were sporadic.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-11
    Survey response — day 21, dose 1
    MedDRA: Cough, Headache, Malaise, Pulmonary congestion, Rales, SARS-CoV-2 test negative — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Symptoms: Apparent congestion in the lungs resulting in crackling noises while exhaling, most noticeable when attempting to sleep, accompanied by minor coughing, minor headache and general feeling of malaise that varies during the day. · Healthcare visit (other): Had Negative COVID19 PCR test (Upper Respiratory Tract Swab)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-11
    Report sent to call center — day 21, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  12. 2021-04-13
    Dose 2 — Pfizer-BioNTech
  13. 2021-04-18
    Survey response — days 1–6 daily, dose 2
    MedDRA: Noninfective gingivitis — Feeling: Fair
    Free text: Gum inflammation, which happens almost every time I get a cold (except I did not get a cold)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-19
    Survey response — days 1–6 daily, dose 2
    MedDRA: Gingival pain, Noninfective gingivitis — Feeling: Fair
    Free text: Painful gum inflammation
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-22
    Health check-in — day 7, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  16. 2021-04-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-05-04
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-05-11
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-05-18
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-05-26
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-07-13
    Survey response — 3 months, dose 2
    MedDRA: Tooth extraction, Tooth fracture — Feeling: Good · 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: Split tooth, required extraction.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-07-13
    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)
  23. 2021-07-15
  24. 2021-07-21
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  25. 2021-10-12
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2022-03-21
    Dose 3 — Pfizer-BioNTech
  27. 2022-04-13
    Health check-in — 12 months, dose 2
    Feeling: Fair
    Adult check-in
  28. 2022-06-21
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  29. 2022-08-12
    Dose 4 — Moderna
  30. 2022-08-21
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  31. 2022-08-28
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  32. 2022-09-02
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  33. 2022-09-09
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  34. 2022-09-17
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  35. 2022-11-10
    Dose 5 — Pfizer-BioNTech
    Co-administered: Flu
  36. 2022-11-13
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · Site: Pain · Muscle or body aches
    Adult check-in
  37. 2022-11-13
    Survey response — 3 months, dose 4
    MedDRA: Chills, Pain, Pyrexia — Feeling: Good · Be unable to do your normal daily activities
    Free text: Slight fever, chills, aches following bivalent covid booster and same day flu shot. Resolved within 48 hrs.
    MedDRA releases: 2024-11 · check-in free text available
  38. 2022-11-14
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · Site: Itching · Muscle or body aches
    Adult check-in
  39. 2022-11-15
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · Headache, Fatigue or tiredness
    Adult check-in
  40. 2022-11-16
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · None
    Adult check-in
  41. 2022-11-17
    Health check-in — day 7, dose 5
    Feeling: Good · None
    Adult check-in
  42. 2022-11-25
    Survey response — day 14, dose 5
    MedDRA: Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Sore throat, congestion, runny nose
    MedDRA releases: 2024-11 · check-in free text available
  43. 2022-12-08
    Health check-in — day 28, dose 5
    Feeling: Good
    Adult check-in
  44. 2022-12-17
    Health check-in — day 35, dose 5
    Feeling: Good
    Adult check-in
  45. 2022-12-22
    Health check-in — day 42, dose 5
    Feeling: Good
    Adult check-in
  46. 2023-02-09
    Survey response — 3 months, dose 5
    MedDRA: Eye infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  47. 2023-02-09
    Report sent to call center — 3 months, dose 5
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  48. 2023-02-10

Vaccinations

DoseDateManufacturerCo-administered
12021-03-21Pfizer-BioNTech
22021-04-13Pfizer-BioNTech
32022-03-21Pfizer-BioNTech No
42022-08-12Moderna No
52022-11-10Pfizer-BioNTech Flu

Call center

ReportedOutcomeVAERS-related outcome
2021-04-11 Successful Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-07-13 Successful
2021-07-21
 Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2023-02-09 Unsuccessful

Free text

Release 6 — day 14, dose 1

2021-04-04

Symptoms: In the 9 days following vaccine felt ill periodically: general malaise, sore muscles, headaches, may have had slight fever. These symptoms were sporadic.

Release 7 — day 21, dose 1

2021-04-11

Symptoms: Apparent congestion in the lungs resulting in crackling noises while exhaling, most noticeable when attempting to sleep, accompanied by minor coughing, minor headache and general feeling of malaise that varies during the day.
Healthcare visit (other): Had Negative COVID19 PCR test (Upper Respiratory Tract Swab)

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): Gum inflammation, which happens almost every time I get a cold (except I did not get a cold)

2021-04-19

Systemic reaction (other): Painful gum inflammation

Release 9 — 3 months, dose 2

2021-07-13

Symptoms: Split tooth, required extraction.

Release 12 — 3 months, dose 4

2022-11-13

Symptoms: Slight fever, chills, aches following bivalent covid booster and same day flu shot. Resolved within 48 hrs.

Release 12 — day 14, dose 5

2022-11-25

Symptoms: Sore throat, congestion, runny nose

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

FieldPreferred term2021-092023-042024-11
HCVOSARS-CoV-2 test negative ✓ ✓ ✓
SDChills · · ✓
SDCough ✓ ✓ ✓
SDEye infection · · ✓
SDHeadache ✓ ✓ ✓
SDMalaise ✓ ✓ ✓
SDMyalgia ✓ ✓ ✓
SDOropharyngeal pain · · ✓
SDPain · · ✓
SDPulmonary congestion ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDRales ✓ ✓ ✓
SDRespiratory tract congestion · · ✓
SDRhinorrhoea · · ✓
SDTooth extraction ✓ ✓ ✓
SDTooth fracture ✓ ✓ ✓
SROGingival pain ✓ ✓ ✓
SRONoninfective gingivitis ✓ ✓ ✓

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

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