3SD-39467-53973

5 vaccinations 11 coded responses 35 check-ins 10 free-text entries 5 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 220 / VA
Registered: 2021-03-16

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

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
2628417 (opens in a new window)	high	9 / 11	1	1 of 8 VAERS symptoms	same dose (4)	VA matches	2022-05-06 / 2022-06-05 / 2023-05-08 received the same day as the last call	case 1153290

From the VAERS matching of call center cases (loader/vaers_match_*). Only the best match is shown, and only if it scores 8 or more out of 11. The score adds up timing (VAERS received soon after the call center contact), dose and shared symptoms; state only breaks ties. Confidence is high when the score is 8+ and at least 3 points ahead of the runner-up, medium when 5+ and 2 ahead, otherwise low. A match is a likely link, not a confirmed one.

Timeline

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

2021-03-06
Dose 1 — Pfizer-BioNTech
2021-03-16
Registered in v-safe
2021-03-16
Survey response — day 7, dose 1
MedDRA: Bacterial test negative, Blood urine present — Feeling: Fair

Free text: Gross blood in urine on Sunday, March 14, 2021. Urine test negative for bacteria.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 14, dose 1
MedDRA: Blood urine present, Office visit, Prostatic haemorrhage — Feeling: Good

Free text: Last week I reported gross blood in my urine over period of 24 hours that then stopped. Never had this before. Tests showed no infection. Urologist believes it was temporary bleeding in prostrate. Prophylactic cystoscopy this coming Tuesday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Dose 2 — Pfizer-BioNTech
2021-03-27
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Good · Joint pains

Free text: Right hip joint, possibly from playing tennis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Joint pains

Free text: Hip

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-17
Survey response — day 21, dose 2
MedDRA: Eczema — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Exzema on left hand

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-24
Survey response — day 28, dose 2
MedDRA: Arthralgia, Eczema, Myalgia, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Some soreness in left wrist and shoulder, probably muscular and due to exercise. Continue treatment for eczema on left hand with prescription steroid cream. · Healthcare visit (other): Dermatologist office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-08
Survey response — day 42, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Left shoulder pain, which I believe is soft tissue issue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-26
Survey response — 3 months, dose 2
MedDRA: Back pain, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Lower back pain, probably sports injury. · Healthcare visit (other): Internists office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-26
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-30
Call successful
Does not wish to fill out VAERS report
2021-06-30
Call successful
Does not wish to fill out VAERS report
2021-06-30
Call successful
Does not wish to fill out VAERS report
2021-09-25
Dose 3 — Pfizer-BioNTech
2021-09-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-03
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-09
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-10-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-26
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-06
Dose 4 — Pfizer-BioNTech
2022-05-15
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-20
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-10
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-19
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-05
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-04
Dose 5 — Pfizer-BioNTech
2022-11-04
Survey response — 6 months, dose 4
MedDRA: Gastritis, Myalgia, Office visit, Physiotherapy — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Gastritis, muscle pain in left hamstring, IT band, glute · Healthcare visit (other): Office visits, physical therapy, colonoscopy-endoscopy

MedDRA releases: 2024-11 · check-in free text available
2022-11-04
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2023-05-06
Survey response — 12 months, dose 4
MedDRA: Gastrooesophageal reflux disease, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-05-06
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-05-08
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in
2023-05-08
Call successful
Completed over the phone
2023-05-08
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-06	Pfizer-BioNTech
2	2021-03-27	Pfizer-BioNTech
3	2021-09-25	Pfizer-BioNTech	No
4	2022-05-06	Pfizer-BioNTech	No
5	2022-11-04	Pfizer-BioNTech	No

Call center

5 call center cases

5 successful

VAERS report filed, before or during a call: 2

See the call center timeline

Free text

Release 5 — day 7, dose 1

2021-03-16

Systemic reaction (other): Gross blood in urine on Sunday, March 14, 2021. Urine test negative for bacteria.

Release 6 — day 14, dose 1

2021-03-20

Symptoms: Last week I reported gross blood in my urine over period of 24 hours that then stopped. Never had this before. Tests showed no infection. Urologist believes it was temporary bleeding in prostrate. Prophylactic cystoscopy this coming Tuesday.

Release 6 — day 0, dose 2

2021-03-27

Systemic reaction (other): No

Release 6 — days 1–6 daily, dose 2

2021-03-31

Systemic reaction (other): Right hip joint, possibly from playing tennis

2021-04-01

Systemic reaction (other): Hip

Release 7 — day 21, dose 2

2021-04-17

Symptoms: Exzema on left hand

Release 7 — day 28, dose 2

2021-04-24

Symptoms: Some soreness in left wrist and shoulder, probably muscular and due to exercise. Continue treatment for eczema on left hand with prescription steroid cream.

Healthcare visit (other): Dermatologist office visit

Release 8 — day 42, dose 2

2021-05-08

Symptoms: Left shoulder pain, which I believe is soft tissue issue.

Release 9 — 3 months, dose 2

2021-06-26

Symptoms: Lower back pain, probably sports injury.

Healthcare visit (other): Internists office

Release 12 — 6 months, dose 4

2022-11-04

Symptoms: Gastritis, muscle pain in left hamstring, IT band, glute

Healthcare visit (other): Office visits, physical therapy, colonoscopy-endoscopy

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	✓	✓	✓
HCVO	Physiotherapy	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Blood urine present	✓	✓	✓
SD	Eczema	✓	✓	✓
SD	Gastritis	·	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Myalgia	·	·	✓
SD	Office visit	✓	✓	✓
SD	Prostatic haemorrhage	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Bacterial test negative	○	✓	○
SRO	Blood urine present	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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