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3KJ-24915-34360

5 vaccinations 7 coded responses 38 check-ins 7 free-text entries 3 call cases
Sex
—
Age at first dose
46-50
ZIP prefix
021 / MA
Registered
2021-02-03
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-03
    Registered in v-safe
  2. 2021-02-03
    Dose 1 — Pfizer-BioNTech
  3. 2021-02-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Herpes simplex, Pain, Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: Herpes flare soreness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-02-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-10
    Health check-in — day 7, dose 1
    Feeling: Good · Muscle or body aches
    Adult check-in
  8. 2021-02-17
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-02-24
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-03-03
    Dose 2 — Pfizer-BioNTech
  11. 2021-03-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fever · None
    Adult check-in
  12. 2021-03-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  13. 2021-03-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-03-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-03-10
    Health check-in — day 7, dose 2
    Feeling: Good · Joint pains, Muscle or body aches
    Adult check-in
  16. 2021-03-17
    Survey response — day 14, dose 2
    MedDRA: Oropharyngeal pain — Feeling: Good
    Free text: Sore throat
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-24
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-04-04
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-04-07
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-04-14
    Survey response — day 42, dose 2
    MedDRA: Dizziness, Nausea — Feeling: Good
    Free text: Dizziness, nausea
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-06-04
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-09-01
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-09-10
    Dose 3 — Pfizer-BioNTech
  24. 2021-10-01
    Survey response — day 21, dose 3
    MedDRA: Alopecia, COVID-19, Condition aggravated, Pain, Pre-existing disease, Psoriatic arthropathy, Unevaluable event — 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: Symptoms: Psoriatic arthritis flare approximately two weeks post vaccination. · Healthcare visit (other): Started meloxicam for pain; stopped Plaquenil for enthesis and alopecia. Timing of flare was likely just coincidental; have needed stronger autoimmune regimen and dx pathway decided just as covid hit. Treatment delayed by pandemic.
    MedDRA releases: 2024-11 · check-in free text available
  25. 2021-10-01
    Report sent to call center — day 21, 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)
  26. 2021-10-06
  27. 2021-10-10
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  28. 2021-10-15
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  29. 2021-10-22
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  30. 2021-12-12
    Survey response — 3 months, dose 3
    MedDRA: Rectal haemorrhage, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Symptoms: Occasional rectal bleeding · Healthcare visit (other): Visit just occurred Friday. Need to submit fit stool sample then go from there
    MedDRA releases: 2024-11 · check-in free text available
  31. 2021-12-12
    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)
  32. 2021-12-13
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  33. 2022-06-16
    Dose 4 — Pfizer-BioNTech
    Co-administered: Shingles
  34. 2022-06-25
    Health check-in — day 7, dose 4
    Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  35. 2022-06-30
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  36. 2022-07-07
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  37. 2022-07-15
    Health check-in — day 28, dose 4
    Feeling: Fair
    Adult check-in
  38. 2022-07-23
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  39. 2022-07-28
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  40. 2022-09-18
    Survey response — 3 months, dose 4
    MedDRA: Hypersensitivity, Pre-existing disease, Upper-airway cough syndrome — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Exacerbated allergy symptoms; mucous pooling
    MedDRA releases: 2024-11 · check-in free text available
  41. 2022-11-23
    Dose 5 — Moderna
    Co-administered: Flu
  42. 2022-11-30
    Survey response — day 7, dose 5
    MedDRA: Nasal congestion, Office visit, Pre-existing disease, Respiratory tract congestion — Feeling: Fair · Site: Pain · Fatigue or tiredness · Get care from a doctor or other healthcare professional
    Free text: Systemic reaction (other): Post-nasal congestion; do have high level dust mite allergy · Healthcare visit (other): Following up with ENT regarding congestion, but, again, it could be worsening allergies
    MedDRA releases: 2024-11 · check-in free text available
  43. 2022-11-30
    Report sent to call center — day 7, dose 5
    Get care from a doctor or other healthcare professional
    1 call case(s)
  44. 2022-12-01
    Call successful
    Does not wish to fill out VAERS report
  45. 2022-12-07
    Health check-in — day 14, dose 5
    Feeling: Fair
    Adult check-in
  46. 2022-12-14
    Health check-in — day 21, dose 5
    Feeling: Fair
    Adult check-in
  47. 2022-12-22
    Health check-in — day 28, dose 5
    Feeling: Fair
    Adult check-in
  48. 2022-12-28
    Health check-in — day 35, dose 5
    Feeling: Good
    Adult check-in
  49. 2023-02-24
    Health check-in — 3 months, dose 5
    Feeling: Good
    Adult check-in
  50. 2023-05-26
    Health check-in — 6 months, dose 5
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-03Pfizer-BioNTech
22021-03-03Pfizer-BioNTech
32021-09-10Pfizer-BioNTech No
42022-06-16Pfizer-BioNTech Shingles
52022-11-23Moderna Flu

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): Herpes flare soreness

Release 5 — day 14, dose 2

2021-03-17

Symptoms: Sore throat

Release 7 — day 42, dose 2

2021-04-14

Symptoms: Dizziness, nausea

Release 9 — day 21, dose 3

2021-10-01

Symptoms: Psoriatic arthritis flare approximately two weeks post vaccination.
Healthcare visit (other): Started meloxicam for pain; stopped Plaquenil for enthesis and alopecia. Timing of flare was likely just coincidental; have needed stronger autoimmune regimen and dx pathway decided just as covid hit. Treatment delayed by pandemic.

Release 10 — 3 months, dose 3

2021-12-12

Symptoms: Occasional rectal bleeding
Healthcare visit (other): Visit just occurred Friday. Need to submit fit stool sample then go from there

Release 12 — 3 months, dose 4

2022-09-18

Symptoms: Exacerbated allergy symptoms; mucous pooling

Release 12 — day 7, dose 5

2022-11-30

Systemic reaction (other): Post-nasal congestion; do have high level dust mite allergy
Healthcare visit (other): Following up with ENT regarding congestion, but, again, it could be worsening allergies

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

FieldPreferred term2021-092023-042024-11
HCVOAlopecia · · ✓
HCVOCondition aggravated · · ✓
HCVOCOVID-19 · · ✓
HCVOOffice visit · · ✓
HCVOPain · · ✓
HCVOPre-existing disease · · ✓
HCVORespiratory tract congestion · · ✓
HCVOUnevaluable event · · ✓
SDDizziness ✓ ✓ ✓
SDHypersensitivity · · ✓
SDNausea ✓ ✓ ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPre-existing disease · · ✓
SDPsoriatic arthropathy · · ✓
SDRectal haemorrhage · · ✓
SDUpper-airway cough syndrome · · ✓
SROHerpes simplex ✓ ✓ ✓
SRONasal congestion · · ✓
SROPain ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

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

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