2JV-12079-76706

4 vaccinations 15 coded responses 27 check-ins 15 free-text entries 6 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 303 / GA
Registered: 2021-01-28

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Pfizer-BioNTech
2021-01-28
Survey response — day 0, dose 1
MedDRA: Nasal congestion — Feeling: Good

Free text: Stuffy nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Headache

Free text: Dizziness the day following the vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-02-04
Survey response — day 7, dose 1
MedDRA: Dizziness — Feeling: Good · Diarrhea · Be unable to work

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-18
Dose 2 — Pfizer-BioNTech
2021-02-18
Health check-in — day 0, dose 2
Feeling: Good · Site: Swelling · Chills, Fatigue or tiredness

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good

Free text: Day 3 after 2nd dose much improved

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-25
Health check-in — day 7, dose 2
Feeling: Fair · Site: Swelling · Joint pains

Adult check-in
2021-03-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Survey response — day 42, dose 2
MedDRA: Feeling abnormal, Vertigo — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Fuzzy headed and vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Report sent to call center — day 42, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-21
Survey response — 3 months, dose 2
MedDRA: Atrial fibrillation, Medical counselling — 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, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Atril fibrilation · Healthcare visit (other): Tests upon tests

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
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)
2021-06-16
Call successful
Participant prefers to complete VAERS report online
2021-06-16
Call successful
Participant prefers to complete VAERS report online
2021-08-20
Survey response — 6 months, dose 2
MedDRA: No adverse event, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: None from the vaccines. · Healthcare visit (other): Mutiple tests, cardio and blood

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-20
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-24
Call 1 — Left Voicemail
2021-08-25
Call successful
Participant prefers to complete VAERS report online
2021-09-21
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-10-06
Survey response — day 14, dose 3
MedDRA: Fatigue, Joint swelling, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue and joint swelling · Healthcare visit (other): Saw oncologist

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Report sent to call center — day 14, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-28
Survey response — day 35, dose 3
MedDRA: Back pain, Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Liwer back ache, intermittant fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-12-21
Survey response — 3 months, dose 3
MedDRA: Cough, Influenza, Muscular weakness, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activities

Free text: 10 days of flu (CDC-winter Crud) negative COVID rapid test. Fever, sore throat, cough (violent) , chest congestion, body aches and fatigue in the extremis!

MedDRA releases: 2024-11 · check-in free text available
2022-03-26
Survey response — 6 months, dose 3
MedDRA: Diarrhoea, Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Diarrhea, fatique

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Dose 4 — Moderna
2022-05-14
Survey response — day 35, dose 4
MedDRA: Lymphadenopathy, Malaise, Pyrexia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Really poor reaction to the Moderna boister. Swelling in lymph glands, fever, malaise for 23 days after. My MD said i had a "very 'robust' immune system reaction to this dose." Twas not pleasant.

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-07
Survey response — 3 months, dose 4
MedDRA: Renal pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Kidney pain

MedDRA releases: 2024-11 · check-in free text available
2022-07-07
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-08
Call successful
Participant prefers to complete VAERS report online
2022-10-04
Survey response — 6 months, dose 4
MedDRA: Chemotherapy, Chronic lymphocytic leukaemia — 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: CLL (leukemia). Now undergoing chemo infusion

MedDRA releases: 2024-11 · check-in free text available
2022-10-04
Report sent to call center — 6 months, dose 4
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)
2022-10-05
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Pfizer-BioNTech
2	2021-02-18	Pfizer-BioNTech
3	2021-09-21	Pfizer-BioNTech	Flu
4	2022-04-05	Moderna	No

Call center

6 call center cases

6 successful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-28

Systemic reaction (other): Stuffy nose

Release 3 — days 1–6 daily, dose 1

2021-01-30

Systemic reaction (other): Dizziness the day following the vaccination.

2021-02-02

Systemic reaction (other): Dizziness

Release 3 — day 7, dose 1

2021-02-04

Systemic reaction (other): Dizzy

Release 4 — days 1–6 daily, dose 2

2021-02-21

Systemic reaction (other): Day 3 after 2nd dose much improved

Release 6 — day 42, dose 2

2021-04-01

Symptoms: Fuzzy headed and vertigo

Release 8 — 3 months, dose 2

2021-05-21

Symptoms: Atril fibrilation

Healthcare visit (other): Tests upon tests

Release 9 — 6 months, dose 2

2021-08-20

Symptoms: None from the vaccines.

Healthcare visit (other): Mutiple tests, cardio and blood

Release 10 — day 14, dose 3

2021-10-06

Symptoms: Fatigue and joint swelling

Healthcare visit (other): Saw oncologist

Release 10 — day 35, dose 3

2021-10-28

Symptoms: Liwer back ache, intermittant fatigue

Release 10 — 3 months, dose 3

2021-12-21

Symptoms: 10 days of flu (CDC-winter Crud) negative COVID rapid test. Fever, sore throat, cough (violent) , chest congestion, body aches and fatigue in the extremis!

Release 11 — 6 months, dose 3

2022-03-26

Symptoms: Diarrhea, fatique

Release 11 — day 35, dose 4

2022-05-14

Symptoms: Really poor reaction to the Moderna boister. Swelling in lymph glands, fever, malaise for 23 days after. My MD said i had a "very 'robust' immune system reaction to this dose." Twas not pleasant.

Release 12 — 3 months, dose 4

2022-07-07

Symptoms: Kidney pain

Release 12 — 6 months, dose 4

2022-10-04

Symptoms: CLL (leukemia). Now undergoing chemo infusion

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	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
HCVO	Unevaluable event	✓	·	✓
SD	Atrial fibrillation	✓	✓	✓
SD	Back pain	·	·	✓
SD	Chemotherapy	·	·	✓
SD	Chronic lymphocytic leukaemia	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling abnormal	✓	✓	✓
SD	Influenza	·	·	✓
SD	Joint swelling	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Malaise	·	·	✓
SD	Muscular weakness	·	·	✓
SD	No adverse event	✓	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Renal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vertigo	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓

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