ZLH-30586-01733

5 vaccinations 7 coded responses 31 check-ins 7 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 130 / NY
Registered: 2021-03-04

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

2021-01-31
Dose 1 — Pfizer-BioNTech
2021-02-21
Dose 2 — Pfizer-BioNTech
2021-03-04
Registered in v-safe
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-20
Dose 3 — Pfizer-BioNTech
2021-10-01
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-04
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-11
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-20
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-01
Health check-in — day 42, dose 3
Feeling: Good

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

Adult check-in
2022-03-21
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-01
Dose 4 — Pfizer-BioNTech
2022-04-14
Survey response — day 7, dose 4
MedDRA: Pain in extremity — Feeling: Good

Free text: Mild arm pain day 1 post shot

MedDRA releases: 2024-11 · check-in free text available
2022-04-15
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-22
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-29
Survey response — day 28, dose 4
MedDRA: Rhinorrhoea — Feeling: Good

Free text: Sniffles. Allergies??

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Survey response — day 35, dose 4
MedDRA: Cough, Fatigue, Nasopharyngitis, Rhinorrhoea, Sinus headache, Sneezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Got a full blown head cold as did my wife intense sneezing, intense runny nose, feeling tired..light cough sone sinus headache. Tested twice and NO Covid duration 8 to 10!days start to finish.

MedDRA releases: 2024-11 · check-in free text available
2022-05-15
Survey response — day 42, dose 4
MedDRA: Nasopharyngitis, Pre-existing disease, Rhinorrhoea, Sneezing — Feeling: Good

Free text: Very bad head cold with duration 8 to 9 days. Excessive sneezing fur two full days. Very runny nose. Thought it was allergies initially. Not so. Wife had exact same cold. Same duration. Hough probability it was caught from visit with grand children

MedDRA releases: 2024-11 · check-in free text available
2022-07-01
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-19
Dose 5 — Pfizer-BioNTech
2022-09-27
Survey response — day 7, dose 5
MedDRA: SARS-CoV-2 test positive — Feeling: Poor · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Yes, tested first time today positive for covid

MedDRA releases: 2024-11 · check-in free text available
2022-09-27
Report sent to call center — day 7, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-09-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-03
Survey response — day 14, dose 5
MedDRA: COVID-19, Cough, Decreased appetite, Productive cough — 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

Free text: Appetite is light, dry cough especially nights, some sputum, improving daily from covid.

MedDRA releases: 2024-11 · check-in free text available
2022-10-03
Report sent to call center — day 14, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-10
Survey response — day 21, dose 5
MedDRA: Productive cough — Feeling: Good

Free text: Increased cough with phlegm at night, early morning and before bed

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-28
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-31
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-19
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-20
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-31	Pfizer-BioNTech
2	2021-02-21	Pfizer-BioNTech
3	2021-09-20	Pfizer-BioNTech	No
4	2022-04-01	Pfizer-BioNTech	No
5	2022-09-19	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-09-27	Successful 2022-09-28	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-03	Successful 2022-10-05	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 11 — day 7, dose 4

2022-04-14

Systemic reaction (other): Mild arm pain day 1 post shot

Release 11 — day 28, dose 4

2022-04-29

Symptoms: Sniffles. Allergies??

Release 11 — day 35, dose 4

2022-05-06

Symptoms: Got a full blown head cold as did my wife intense sneezing, intense runny nose, feeling tired..light cough sone sinus headache. Tested twice and NO Covid duration 8 to 10!days start to finish.

Release 11 — day 42, dose 4

2022-05-15

Symptoms: Very bad head cold with duration 8 to 9 days. Excessive sneezing fur two full days. Very runny nose. Thought it was allergies initially. Not so. Wife had exact same cold. Same duration. Hough probability it was caught from visit with grand children cut off by CDC

Release 12 — day 7, dose 5

2022-09-27

Systemic reaction (other): Yes, tested first time today positive for covid

Release 12 — day 14, dose 5

2022-10-03

Symptoms: Appetite is light, dry cough especially nights, some sputum, improving daily from covid.

Release 12 — day 21, dose 5

2022-10-10

Symptoms: Increased cough with phlegm at night, early morning and before bed

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	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Fatigue	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Productive cough	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinus headache	·	·	✓
SD	Sneezing	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	SARS-CoV-2 test positive	·	·	✓

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