2JV-58076-45417
4 vaccinations
4 coded responses
25 check-ins
4 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 958 / CA
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-17
Dose 1 — Pfizer-BioNTech
-
2021-03-10
Registered in v-safe
-
2021-03-10
Dose 2 — Pfizer-BioNTech
- 2021-03-10
- 2021-03-11
-
2021-03-12
Survey response — days 1–6 daily, dose 2MedDRA: Chills — Feeling: Good · Site: PainFree text: Yesterday after the badge report I developed chills for about 30 minutesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-24
- 2021-04-01
- 2021-04-07
-
2021-04-14
Survey response — day 35, dose 2MedDRA: Chills, Emergency care, Gastrooesophageal reflux disease, Malaise, Pyrexia, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: Low fever, chills for two days. Extreme prolonged GERD causing me to call paramedics and then go to ER. Concerned about possible heart attack. It was GERD. Still Ill. · Healthcare visit (other): ParamedicsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-14
Report sent to call center — day 35, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-21
Survey response — day 42, dose 2MedDRA: Chills, Emergency care, Fatigue, Gastrooesophageal reflux disease, Influenza, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Major GERD resulting in ER visit in case it was heart attack. Immediately followed by two days flu symptoms (101.5 fever, chills, nausea) and several days of lessening fatigue. PCR COVID test was negative.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-21
Report sent to call center — day 42, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-09
Survey response — 3 months, dose 2MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Heart having 25-30% PVCs. Ive had a low level of PVCs for years, but the rate has increased significantly recently. Working with cardiologist.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-09
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-11
-
2021-08-12
Call successfulParticipant prefers to complete VAERS report online
- 2021-09-08
-
2021-10-27
Dose 3 — Moderna
- 2022-03-10
-
2022-04-29
Dose 4 — Pfizer-BioNTech
- 2022-05-08
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-06-10
- 2022-07-29
- 2022-10-28
- 2023-04-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-17 | Pfizer-BioNTech | |
| 2 | 2021-03-10 | Pfizer-BioNTech | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-29 | Pfizer-BioNTech | No |
Call center
3 call center cases
3 successful
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Yesterday after the badge report I developed chills for about 30 minutes
Release 7 — day 35, dose 2
Symptoms: Low fever, chills for two days. Extreme prolonged GERD causing me to call paramedics and then go to ER. Concerned about possible heart attack. It was GERD. Still Ill.
Healthcare visit (other): Paramedics
Release 7 — day 42, dose 2
Symptoms: Major GERD resulting in ER visit in case it was heart attack. Immediately followed by two days flu symptoms (101.5 fever, chills, nausea) and several days of lessening fatigue. PCR COVID test was negative.
Release 9 — 3 months, dose 2
Symptoms: Heart having 25-30% PVCs. Ive had a low level of PVCs for years, but the rate has increased significantly recently. Working with cardiologist.
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 | Emergency care | ✓ | · | ✓ |
| HCVO | Unevaluable event | ○ | ✓ | ○ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Gastrooesophageal reflux disease | ✓ | ✓ | ✓ |
| SD | Influenza | ✓ | ✓ | ✓ |
| SD | Malaise | ✓ | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release