2JP-13960-14165

4 vaccinations 7 coded responses 20 check-ins 7 free-text entries 7 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 498 / MI
Registered: 2021-01-13

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

2020-12-22
Dose 1 — Pfizer-BioNTech
2021-01-12
Dose 2 — Pfizer-BioNTech
2021-01-13
Registered in v-safe
2021-01-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-18
Survey response — day 35, dose 2
MedDRA: Adverse reaction — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: I am being work up for IgG4RD, and may be getting close to a diagnosis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-25
Survey response — day 42, dose 2
MedDRA: Fatigue, Lymphadenopathy mediastinal, Pulmonary mass — 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, Emergency room or emergency department visit

Free text: Fatigue, mediastinal lymphadenopathy, pulmonary masses.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-13
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-13
Survey response — 6 months, dose 2
MedDRA: Osteoarthritis — 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: Right knee osteoarthritis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-13
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-15
Call 1 — Left Voicemail
2021-07-31
Call 2 — Requested Callback
2021-09-01
Dose 3 — Pfizer-BioNTech
2021-10-01
Survey response — day 28, dose 3
MedDRA: Cerebrovascular accident, Ligament sprain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Small stroke.Right knee strain.

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Report sent to call center — day 28, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-10-04
Call successful
Does not wish to fill out VAERS report
2021-10-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-13
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2021-12-03
Survey response — 3 months, dose 3
MedDRA: Muscle spasms — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Muscle spasms in left upper trapezius and rhomboid area.

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-17
Dose 4 — Moderna
2022-03-02
Survey response — 6 months, dose 3
MedDRA: Bursitis, Nasal congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Nasal stuffiness, right olecranon bursitis

MedDRA releases: 2024-11 · check-in free text available
2022-03-02
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-03
Call 1 — Left Voicemail
2022-03-04
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-19
Survey response — 3 months, dose 4
MedDRA: Condition aggravated, Office visit, Pre-existing disease, Pulmonary mass — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: My IgG4 disease has provided me a new lung lesion. I am back on 40 mg of prednisone/ day and will have another CT in about 3 weeks to monitor the lesion. Am feeling better on the steroid. · Healthcare visit (other): Office visit

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-20
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-19
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-02-17
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-22	Pfizer-BioNTech
2	2021-01-12	Pfizer-BioNTech
3	2021-09-01	Pfizer-BioNTech	No
4	2022-02-17	Moderna	No

Call center

7 call center cases

7 successful

See the call center timeline

Free text

Release 4 — day 35, dose 2

2021-02-18

Symptoms: I am being work up for IgG4RD, and may be getting close to a diagnosis.

Release 4 — day 42, dose 2

2021-02-25

Symptoms: Fatigue, mediastinal lymphadenopathy, pulmonary masses.

Release 9 — 6 months, dose 2

2021-07-13

Symptoms: Right knee osteoarthritis.

Release 9 — day 28, dose 3

2021-10-01

Symptoms: Small stroke.Right knee strain.

Release 10 — 3 months, dose 3

2021-12-03

Symptoms: Muscle spasms in left upper trapezius and rhomboid area.

Release 11 — 6 months, dose 3

2022-03-02

Symptoms: Nasal stuffiness, right olecranon bursitis

Release 11 — 3 months, dose 4

2022-05-19

Symptoms: My IgG4 disease has provided me a new lung lesion. I am back on 40 mg of prednisone/ day and will have another CT in about 3 weeks to monitor the lesion. Am feeling better on the steroid.

Healthcare visit (other): Office visit

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	Office visit	·	·	✓
SD	Adverse reaction	✓	✓	✓
SD	Bursitis	·	·	✓
SD	Cerebrovascular accident	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Ligament sprain	·	·	✓
SD	Lymphadenopathy mediastinal	✓	✓	✓
SD	Muscle spasms	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Osteoarthritis	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Pulmonary mass	✓	✓	✓

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