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3QT-33962-12670

3 vaccinations 5 coded responses 27 check-ins 5 free-text entries 5 call cases
Sex
Male
Age at first dose
66+
ZIP prefix
136 / NY
Registered
2021-01-18
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-18
    Registered in v-safe
  2. 2021-01-18
    Dose 1 — Pfizer-BioNTech
  3. 2021-01-18
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-01-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-01-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-01-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-24
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-25
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-01
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-08
    Dose 2 — Pfizer-BioNTech
  12. 2021-02-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  13. 2021-02-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-02-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-02-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  16. 2021-02-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling · None · Be unable to do your normal daily activities
    Adult check-in
  17. 2021-02-15
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling · None · Be unable to do your normal daily activities
    Adult check-in
  18. 2021-02-22
    Survey response — day 14, dose 2
    MedDRA: Deep vein thrombosis, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: I developed a DVT in my left arm, the arm I had the vaccine in. My blood thinner was changed from Xarelto to Lovenox. I also have had a rash on my back, stomach, arms and legs. Benadryl has helped and that is much better the last couple of days.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-02-22
    Report sent to call center — day 14, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  20. 2021-03-01
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-03-08
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-15
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-22
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-05-10
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-08-14
    Survey response — 6 months, dose 2
    MedDRA: Myelodysplastic syndrome unclassifiable — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Diagnosed with MDS-U (13q)
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  26. 2021-08-14
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  27. 2021-08-17
  28. 2021-08-21
  29. 2021-08-30
    Dose 3 — Pfizer-BioNTech
  30. 2021-09-08
    Call successful
    Participant prefers to complete VAERS report online
  31. 2021-09-08
    Call successful
    Participant prefers to complete VAERS report online
  32. 2021-09-30
    Survey response — day 28, dose 3
    MedDRA: Acute kidney injury, Acute respiratory failure, Adrenal insufficiency, Hospitalisation, Inflammation, Shock — 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 · Emergency room or emergency department visit, Hospitalization
    Free text: The day after 3rd vaccineacute respiratory failure, AKI, and shock. No organisms were identified. The conclusion was a robust inflammatory response to the vaccination which triggered adrenal insufficiency. I spent 6 days in hospital 8/31-9/6
    MedDRA releases: 2024-11 · check-in free text available
  33. 2021-09-30
    Report sent to call center — day 28, dose 3
    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 · Hospitalization · 1 call case(s)
  34. 2021-10-04
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  35. 2021-10-04
    Call successful
    Reported to VAERS voluntarily prior to GDIT contact
  36. 2021-10-11
    Health check-in — day 42, dose 3
    Feeling: Fair
    Adult check-in
  37. 2021-12-03
    Health check-in — 3 months, dose 3
    Feeling: Fair
    Adult check-in
  38. 2022-02-28
    Survey response — 6 months, dose 3
    MedDRA: Localised infection, Pre-existing disease, Staphylococcal infection, Thrombocytopenia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit
    Free text: Thrombocytopenia requiring Promacta/Elthrombopag MRSA of toe
    MedDRA releases: 2024-11 · check-in free text available
  39. 2022-02-28
    Report sent to call center — 6 months, dose 3
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
  40. 2022-03-01
    Call successful
    Reported to VAERS voluntarily prior to GDIT contact
  41. 2022-08-30
    Survey response — 12 months, dose 3
    MedDRA: Anaemia — 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
    Free text: Worsening anemia requiring blood transfusions
    MedDRA releases: 2024-11 · check-in free text available
  42. 2022-08-30
    Report sent to call center — 12 months, dose 3
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  43. 2022-08-31

Vaccinations

DoseDateManufacturerCo-administered
12021-01-18Pfizer-BioNTech
22021-02-08Pfizer-BioNTech
32021-08-30Pfizer-BioNTech No

Call center

5 call center cases

4 successful · 1 unsuccessful

VAERS report filed, before or during a call: 2

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — day 14, dose 2

2021-02-22

Symptoms: I developed a DVT in my left arm, the arm I had the vaccine in. My blood thinner was changed from Xarelto to Lovenox. I also have had a rash on my back, stomach, arms and legs. Benadryl has helped and that is much better the last couple of days.

Release 9 — 6 months, dose 2

2021-08-14

Symptoms: Diagnosed with MDS-U (13q)

Release 9 — day 28, dose 3

2021-09-30

Symptoms: The day after 3rd vaccineacute respiratory failure, AKI, and shock. No organisms were identified. The conclusion was a robust inflammatory response to the vaccination which triggered adrenal insufficiency. I spent 6 days in hospital 8/31-9/6

Release 11 — 6 months, dose 3

2022-02-28

Symptoms: Thrombocytopenia requiring Promacta/Elthrombopag MRSA of toe

Release 12 — 12 months, dose 3

2022-08-30

Symptoms: Worsening anemia requiring blood transfusions

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
SDAcute kidney injury · · ✓
SDAcute respiratory failure · · ✓
SDAdrenal insufficiency · · ✓
SDAnaemia · · ✓
SDDeep vein thrombosis ✓ ✓ ✓
SDHospitalisation · · ✓
SDInflammation · · ✓
SDLocalised infection · · ✓
SDMyelodysplastic syndrome unclassifiable ✓ · ✓
SDPre-existing disease · · ✓
SDRash ✓ ✓ ✓
SDShock · · ✓
SDStaphylococcal infection · · ✓
SDThrombocytopenia · · ✓

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

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