37C-12475-99991

5 vaccinations 8 coded responses 25 check-ins 8 free-text entries 3 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 306 / GA
Registered: 2021-01-21

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-20
Dose 1 — Pfizer-BioNTech
2021-01-21
Registered in v-safe
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-10
Dose 2 — Pfizer-BioNTech
2021-02-10
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I feel woozy like Im on a boat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Constipation — Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Free text: Very odd for me, constipation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease, Rash — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Odd. A rash came up out of nowhere on one hand and was gone by morning. My skin is very reactive so it may have been something other than a reaction to the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-17
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-03-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-17
Survey response — day 35, dose 2
MedDRA: Blood urine present, Nephrolithiasis, Rash macular — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Kidney stone with blood in urine, also my skin has little red spots, they aren't sore but look like mosquito bites and are taking a while to heal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Survey response — day 42, dose 2
MedDRA: Nephrolithiasis — Feeling: Good · Be unable to do your normal daily activities

Free text: I had a kidney stone but I dont think its related to the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — 3 months, dose 2
MedDRA: Nephrolithiasis — 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

Free text: Kidney stones

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
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)
2021-08-11
Survey response — 6 months, dose 2
MedDRA: Pre-existing disease, Rhinorrhoea, Sneezing — Feeling: Good

Free text: Runny nose and sneezing. Probably allergies

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-09
Dose 3 — Moderna
2021-12-29
Call 1 — Left Voicemail
2022-04-04
Dose 4 — Pfizer-BioNTech
2022-10-01
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-10-24
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-29
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-05
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-12
Survey response — day 42, dose 5
MedDRA: COVID-19 — Feeling: Poor · 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

Free text: I got covid

MedDRA releases: 2024-11 · check-in free text available
2022-11-12
Report sent to call center — day 42, dose 5
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 · 1 call case(s)
2022-11-14
Call successful
Participant prefers to complete VAERS report online
2023-04-01
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Pfizer-BioNTech
2	2021-02-10	Pfizer-BioNTech
3	2021-11-09	Moderna	No
4	2022-04-04	Pfizer-BioNTech	No
5	2022-10-01	Pfizer-BioNTech	Flu

Call center

3 call center cases

2 successful · 1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): I feel woozy like Im on a boat

2021-02-13

Systemic reaction (other): Very odd for me, constipation

2021-02-15

Systemic reaction (other): Odd. A rash came up out of nowhere on one hand and was gone by morning. My skin is very reactive so it may have been something other than a reaction to the vaccine

Release 5 — day 35, dose 2

2021-03-17

Symptoms: Kidney stone with blood in urine, also my skin has little red spots, they aren't sore but look like mosquito bites and are taking a while to heal

Release 6 — day 42, dose 2

2021-03-24

Symptoms: I had a kidney stone but I dont think its related to the vaccine

Release 8 — 3 months, dose 2

2021-05-12

Symptoms: Kidney stones

Release 9 — 6 months, dose 2

2021-08-11

Symptoms: Runny nose and sneezing. Probably allergies

Release 12 — day 42, dose 5

2022-11-12

Symptoms: I got covid

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	Blood urine present	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Nephrolithiasis	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Rash macular	✓	✓	✓
SD	Rhinorrhoea	✓	·	✓
SD	Sneezing	✓	·	✓
SRO	Constipation	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rash	✓	✓	✓

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