3QF-29214-40993

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

Sex: Male
Age at first dose: 12-15
ZIP prefix: 432 / OH
Registered: 2021-12-08

Relationship: Child or adolescent in my care
Guardian: 9EZ-17842-93183
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-11-08
Dose 1 — Pfizer-BioNTech
2021-11-29
Dose 2 — Pfizer-BioNTech
2021-12-08
Registered in v-safe
2021-12-08
Survey response — day 7, dose 2, dependent
MedDRA: Chest pain, Eye pain, Hypoaesthesia, Hypotension, Office visit, Paraesthesia, Visual impairment — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work or attend school, 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: Systemic reaction (other): Eye pain and changed vision with black spots, chest pain, numb tingling in both arms, low blood pressure, · Healthcare visit (other): Family doctor visit x3. Urgent care upcoming

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Report sent to call center — day 7, dose 2, dependent
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-08
Call 1 — Left Voicemail
2021-12-13
Health check-in — day 14, dose 2, dependent
Feeling: Fair

Adult check-in
2021-12-20
Survey response — day 21, dose 2, dependent
MedDRA: Asthenia, Fatigue, Intracranial pressure increased, Pain — 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 · Emergency room or emergency department visit

Free text: Intercranial pressure. Pain on exertions. Weakness and fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Report sent to call center — day 21, dose 2, dependent
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2021-12-22
Call 1 — Could Not Reach Participant
2021-12-27
Call 2 — Left Voicemail
2022-03-01
Health check-in — 3 months, dose 2, dependent
Feeling: Fair

Adult check-in
2022-06-01
Survey response — 6 months, dose 2, dependent
MedDRA: Asthenia, Autoimmune disorder, Depression, Exercise tolerance decreased, Fatigue, Mental disorder, Migraine with aura, Nervous system disorder, Tachycardia — 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

Free text: Migraines with aura, periodic episodes of tachycardia, undetermined autoimmune or neurological disorders that are being evaluated. Extreme fatigue, weakness, difficulty with physical exertion. Mental health/depression.

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Report sent to call center — 6 months, dose 2, dependent
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 · 1 call case(s)
2022-06-01
Call successful
Participant prefers to complete VAERS report online
2022-06-02
Call successful
Participant prefers to complete VAERS report online
2022-11-29
Survey response — 12 months, dose 2, dependent
MedDRA: Arthralgia, Decreased appetite, Fatigue, General physical condition abnormal, Tachycardia — 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, Outpatient clinic or urgent care clinic visit

Free text: Increased fatigue, joint pain, new episodes of tachycardia, loss of appetite, decrease in endurance

MedDRA releases: 2024-11 · check-in free text available
2022-11-29
Report sent to call center — 12 months, dose 2, dependent
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 · 1 call case(s)
2022-11-30
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-11-08	Pfizer-BioNTech	No
2	2021-11-29	Pfizer-BioNTech	No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 10 — day 7, dose 2, dependent

2021-12-08

Systemic reaction (other): Eye pain and changed vision with black spots, chest pain, numb tingling in both arms, low blood pressure,

Healthcare visit (other): Family doctor visit x3. Urgent care upcoming

Release 10 — day 21, dose 2, dependent

2021-12-20

Symptoms: Intercranial pressure. Pain on exertions. Weakness and fatigue

Release 11 — 6 months, dose 2, dependent

2022-06-01

Symptoms: Migraines with aura, periodic episodes of tachycardia, undetermined autoimmune or neurological disorders that are being evaluated. Extreme fatigue, weakness, difficulty with physical exertion. Mental health/depression.

Release 12 — 12 months, dose 2, dependent

2022-11-29

Symptoms: Increased fatigue, joint pain, new episodes of tachycardia, loss of appetite, decrease in endurance

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	Arthralgia	·	·	✓
SD	Asthenia	·	·	✓
SD	Autoimmune disorder	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Depression	·	·	✓
SD	Exercise tolerance decreased	·	·	✓
SD	Fatigue	·	·	✓
SD	General physical condition abnormal	·	·	✓
SD	Intracranial pressure increased	·	·	✓
SD	Mental disorder	·	·	✓
SD	Migraine with aura	·	·	✓
SD	Nervous system disorder	·	·	✓
SD	Pain	·	·	✓
SD	Tachycardia	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Eye pain	·	·	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Hypotension	·	·	✓
SRO	Paraesthesia	·	·	✓
SRO	Visual impairment	·	·	✓

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