278-29883-12906

4 vaccinations 10 coded responses 33 check-ins 10 free-text entries 2 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 995 / AK
Registered: 2021-03-23

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

2021-03-01
Dose 1 — Pfizer-BioNTech
2021-03-22
Dose 2 — Pfizer-BioNTech
2021-03-23
Registered in v-safe
2021-03-23
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain — Feeling: Good · Site: Pain · Joint pains

Free text: Random chest pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 2
MedDRA: Epistaxis, Flatulence — Feeling: Good · Site: Pain · Joint pains

Free text: Bloody boogers (like when you spend time in the desert) , gas

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Survey response — day 7, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Constant Ear ringing -especially later in the day. This has been happening since the 2nd dose, but didnt really focus on it until last couple days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-09-20
Survey response — 6 months, dose 2
MedDRA: Chest pain, Pain in extremity — Feeling: Good

Free text: Burning ache left chest for about 1 week then went away. Left foot arch pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Dose 3 — Pfizer-BioNTech
2021-12-07
Survey response — days 1–6 daily, dose 3
MedDRA: Chest pain — Feeling: Good · Site: Pain

Free text: AM pain or sharp ache right side of chest for about 30 to 45 min

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-10
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-25
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-14
Survey response — day 42, dose 3
MedDRA: Abdominal pain, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Abdominal pain, fever

MedDRA releases: 2024-11 · check-in free text available
2022-03-04
Survey response — 3 months, dose 3
MedDRA: Gastrointestinal disorder, Pyrexia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: 1week Fever, believe colon (diverticulitis) related, however not diagnosed.

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Survey response — 6 months, dose 3
MedDRA: Abdominal pain — Feeling: Fair · 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: Abdominal pain

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-06
Call 1 — Left Voicemail
2022-06-06
Call successful
Participant prefers to complete VAERS report online
2022-06-22
Dose 4 — Pfizer-BioNTech
2022-06-22
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2022-06-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-06-24
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-06-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-29
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-07-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-20
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-21
Survey response — 6 months, dose 4
MedDRA: Atrioventricular block second degree, Electrocardiogram abnormal, Loss of consciousness, Ventricular tachycardia — Feeling: Good · Be unable to work or attend school, 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: Loss of consciousness, Abnormal EKG, AV 2:1 Heart Block, ventricular tachycardia

MedDRA releases: 2024-11 · check-in free text available
2022-12-21
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-22
Call 1 — Left Voicemail
2022-12-22
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2023-06-22
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Pfizer-BioNTech
2	2021-03-22	Pfizer-BioNTech
3	2021-12-03	Pfizer-BioNTech	No
4	2022-06-22	Pfizer-BioNTech	No

Call center

2 call center cases

2 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-23

Systemic reaction (other): Random chest pain.

2021-03-24

Systemic reaction (other): Bloody boogers (like when you spend time in the desert) , gas

Release 6 — day 7, dose 2

2021-03-31

Systemic reaction (other): Constant Ear ringing -especially later in the day. This has been happening since the 2nd dose, but didnt really focus on it until last couple days.

Release 9 — 6 months, dose 2

2021-09-20

Symptoms: Burning ache left chest for about 1 week then went away. Left foot arch pain

Release 10 — days 1–6 daily, dose 3

2021-12-07

Systemic reaction (other): AM pain or sharp ache right side of chest for about 30 to 45 min

Release 10 — day 42, dose 3

2022-01-14

Symptoms: Abdominal pain, fever

Release 11 — 3 months, dose 3

2022-03-04

Symptoms: 1week Fever, believe colon (diverticulitis) related, however not diagnosed.

Release 11 — 6 months, dose 3

2022-06-03

Symptoms: Abdominal pain

Release 12 — days 1–6 daily, dose 4

2022-06-24

Systemic reaction (other): Sore throat

Release 12 — 6 months, dose 4

2022-12-21

Symptoms: Loss of consciousness, Abnormal EKG, AV 2:1 Heart Block, ventricular tachycardia

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	Abdominal pain	·	·	✓
SD	Atrioventricular block second degree	·	·	✓
SD	Chest pain	·	·	✓
SD	Electrocardiogram abnormal	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Loss of consciousness	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Pyrexia	·	·	✓
SD	Ventricular tachycardia	·	·	✓
SRO	Chest pain	✓	✓	✓
SRO	Epistaxis	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Tinnitus	✓	✓	✓

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