ZRG-77004-90476
4 vaccinations
3 coded responses
10 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 41-45
- ZIP prefix
- 922 / CA
- Registered
- 2021-12-12
- Relationship
- Self
- Race
- N/A
- Ethnicity
- Hispanic or Latino
Registered dependents
MBN-87301-65190
Child or adolescent in my care · Male · 2021-12-12
Timeline
-
2021-03-26
Dose 1 — Pfizer-BioNTech
-
2021-04-16
Dose 2 — Pfizer-BioNTech
-
2021-12-08
Dose 3 — ModernaCo-administered: Flu
-
2021-12-12
Registered in v-safe
-
2021-12-14
Survey response — days 1–6 daily, dose 3MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Seems I have a common cold. I received a COVID rapid test yesterday and was negative.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-15
Survey response — day 7, dose 3MedDRA: Nasal congestion, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion, Unevaluable event — Feeling: Poor · Fatigue or tiredness · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Severe sore throat, chest and nasal congestion, seems like a severe cold. · Healthcare visit (other): I cancelled a dentist appointment to have a crown replaced.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-15
Report sent to call center — day 7, dose 3Get care from a doctor or other healthcare professional1 call case(s)
-
2021-12-16
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-12-24
- 2021-12-29
- 2022-01-06
- 2022-01-19
- 2022-03-09
-
2022-06-08
Survey response — 6 months, dose 3MedDRA: Headache, Nasal congestion, Oropharyngeal pain, Rhinorrhoea, Self-medication — Feeling: FairFree text: Over the past week, I had a headache, soar throat and stuffy/runny nose. The symptoms are subsiding now but were pretty bad. I didn't stop working or any activities because I am taking prescription methylphenidate and Advil to help with symptoms.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-18
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-12-08
- 2023-01-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-26 | Pfizer-BioNTech | No |
| 2 | 2021-04-16 | Pfizer-BioNTech | No |
| 3 | 2021-12-08 | Moderna | Flu |
| 4 | 2022-10-18 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-15 | Successful 2021-12-16 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Seems I have a common cold. I received a COVID rapid test yesterday and was negative.
Release 10 — day 7, dose 3
Systemic reaction (other): Severe sore throat, chest and nasal congestion, seems like a severe cold.
Healthcare visit (other): I cancelled a dentist appointment to have a crown replaced.
Release 11 — 6 months, dose 3
Symptoms: Over the past week, I had a headache, soar throat and stuffy/runny nose. The symptoms are subsiding now but were pretty bad. I didn't stop working or any activities because I am taking prescription methylphenidate and Advil to help with symptoms.
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 | Unevaluable event | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Nasopharyngitis | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
| SRO | SARS-CoV-2 test negative | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release