44S-16823-53951

3 vaccinations 10 coded responses 21 check-ins 10 free-text entries 5 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 917 / CA
Registered: 2021-05-01

Relationship: Self
Race: Native Hawaiian or other Pacific Islander
Ethnicity: Not Hispanic or Latino

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
1925115 (opens in a new window)	high	11 / 11	1	2 of 4 VAERS symptoms	same dose (2)	CA matches	2021-04-28 / 2021-05-12 / 2021-12-06 received 35 days after the last call	case 1137254

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

2021-04-07
Dose 1 — Pfizer-BioNTech
2021-04-28
Dose 2 — Pfizer-BioNTech
2021-05-01
Registered in v-safe
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Nasal congestion — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Severe nasal congestion at bed time. Dull headache most of today. Not sure if it's related as 2nd shot was 4/28, today is 5/1.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Increased viscosity of upper respiratory secretion, Insomnia, Nasal congestion, Nasal mucosal discolouration, Respiratory tract congestion, Sleep disorder — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: ~8-9.5(rating) nasal congestion that is causing my ongoing 5-7 (day-night time rating) headaches. I discharged yellow-green very thick mucus this morning. Congestion severe enough to prove difficult sleeping even in upright position; waking up 2x at night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-05-05
Survey response — day 7, dose 2
MedDRA: Respiratory tract congestion — Feeling: Fair · Rash, not including the immediate area around the injection site

Free text: I continue, albeit much reduced, chest congestion. I think it's almost gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-09
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-28
Survey response — 3 months, dose 2
MedDRA: Bronchitis, Telemedicine — 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: Symptoms: Bronchitis mid May to early July. Pulmonary function test 7/29/21 10:00am. Meds: 2 rounds ea. of steroids, azythromycin, advair. · Healthcare visit (other): 1st round telehealth 1st rnd of meds; 2nd round expedited appt Dr appt for 2nd rnd of stronger meds.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-28
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-10
Call 1 — Left Voicemail
2021-08-16
Call successful
Completed over the phone
2021-10-29
Survey response — 6 months, dose 2
MedDRA: Bronchitis, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: My bronchitis that I first contracted(?) has returned 2 times. Now it seems to be a residual condition that's exacerbated by moderate exercise. I'm very discouraged and dont know what to do, after two pulmonologists & multiple steroids & Rx's. · Healthcare visit (other): Pulmonologist appts. Seeking more help.

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-01
Call successful
Completed over the phone
2021-11-09
Dose 3 — Pfizer-BioNTech
2021-11-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · None

Adult check-in
2021-11-16
Survey response — day 7, dose 3
MedDRA: Bronchitis, Bronchospasm, Office visit, Respiratory tract congestion — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Continued residual congestion from bronchitis in May continuing with bouts of exercise induced broncoconstriction. · Healthcare visit (other): Appt 11/29/21 allergist / immunologist / internal medicine

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Report sent to call center — day 7, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-18
Call 1 — Left Voicemail
2021-11-25
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-29
Call successful
Completed over the phone
2021-12-01
Survey response — day 21, dose 3
MedDRA: Asthenia, Cough, Dyspnoea, Headache, Office visit, Pain, Telemedicine — 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: Symptoms: Coughing shortness of breath headache body aches weakness. Immunologist gave me 2 doses ea epinephrine and albuterol by nebulizer. Dr ordered STAT lab and chest CT for review for next app 12/2/21. · Healthcare visit (other): Outpatient-immunologist Telehealth-PCP

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Report sent to call center — day 21, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-06
Call successful
Completed over the phone
2021-12-07
Survey response — day 28, dose 3
MedDRA: Hospitalisation, Respiratory disorder, Unevaluable event — 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, Hospitalization

Free text: Symptoms: As discussed in my recent vsafe phone conversation with your rep. I remain hospitalized due to respitory health problems. I gave specific medical info where I'm hospitalized and my doctors. · Healthcare visit (other): Info already given in my last phone check up with your vsafe rep.

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
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)
2021-12-09
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-14
Health check-in — day 35, dose 3
Feeling: Poor

Adult check-in
2021-12-23
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-08
Survey response — 3 months, dose 3
MedDRA: Eosinophilic granulomatosis with polyangiitis, Pre-existing disease, Vasculitis — Feeling: Fair

Free text: Since been diagnosed wi/asthma, later changed to a symptom of new diagnosis called Eosinophilic granulomatosis with polyangiitis (EGPA), a rare form of vasculitis that restricts blood vessels and damage vital organs.

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-11-09
Survey response — 12 months, dose 3
MedDRA: Discomfort, Ear discomfort, Fatigue, Head discomfort, Headache — Feeling: Fair

Free text: They may be related to EGPA; dull headaches, head, ear, nos, face pressure, tiredness. But symptoms are not debilitating as to prevent my willingness & ability to work, and ADLs.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-07	Pfizer-BioNTech
2	2021-04-28	Pfizer-BioNTech
3	2021-11-09	Pfizer-BioNTech	No

Call center

5 call center cases

5 successful

VAERS report filed, before or during a call: 4

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-01

Systemic reaction (other): Severe nasal congestion at bed time. Dull headache most of today. Not sure if it's related as 2nd shot was 4/28, today is 5/1.

2021-05-02

Systemic reaction (other): ~8-9.5(rating) nasal congestion that is causing my ongoing 5-7 (day-night time rating) headaches. I discharged yellow-green very thick mucus this morning. Congestion severe enough to prove difficult sleeping even in upright position; waking up 2x at night.

Release 8 — day 7, dose 2

2021-05-05

Systemic reaction (other): I continue, albeit much reduced, chest congestion. I think it's almost gone.

Release 9 — 3 months, dose 2

2021-07-28

Symptoms: Bronchitis mid May to early July. Pulmonary function test 7/29/21 10:00am. Meds: 2 rounds ea. of steroids, azythromycin, advair.

Healthcare visit (other): 1st round telehealth 1st rnd of meds; 2nd round expedited appt Dr appt for 2nd rnd of stronger meds.

Release 10 — 6 months, dose 2

2021-10-29

Symptoms: My bronchitis that I first contracted(?) has returned 2 times. Now it seems to be a residual condition that's exacerbated by moderate exercise. I'm very discouraged and dont know what to do, after two pulmonologists & multiple steroids & Rx's.

Healthcare visit (other): Pulmonologist appts. Seeking more help.

Release 10 — day 7, dose 3

2021-11-16

Systemic reaction (other): Continued residual congestion from bronchitis in May continuing with bouts of exercise induced broncoconstriction.

Healthcare visit (other): Appt 11/29/21 allergist / immunologist / internal medicine

Release 10 — day 21, dose 3

2021-12-01

Symptoms: Coughing shortness of breath headache body aches weakness. Immunologist gave me 2 doses ea epinephrine and albuterol by nebulizer. Dr ordered STAT lab and chest CT for review for next app 12/2/21.

Healthcare visit (other): Outpatient-immunologist Telehealth-PCP

Release 10 — day 28, dose 3

2021-12-07

Symptoms: As discussed in my recent vsafe phone conversation with your rep. I remain hospitalized due to respitory health problems. I gave specific medical info where I'm hospitalized and my doctors.

Healthcare visit (other): Info already given in my last phone check up with your vsafe rep.

Release 11 — 3 months, dose 3

2022-02-08

Symptoms: Since been diagnosed wi/asthma, later changed to a symptom of new diagnosis called Eosinophilic granulomatosis with polyangiitis (EGPA), a rare form of vasculitis that restricts blood vessels and damage vital organs.

Release 12 — 12 months, dose 3

2022-11-09

Symptoms: They may be related to EGPA; dull headaches, head, ear, nos, face pressure, tiredness. But symptoms are not debilitating as to prevent my willingness & ability to work, and ADLs.

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	Telemedicine	✓	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Asthenia	·	·	✓
SD	Bronchitis	✓	·	✓
SD	Cough	·	·	✓
SD	Discomfort	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Ear discomfort	·	·	✓
SD	Eosinophilic granulomatosis with polyangiitis	·	·	✓
SD	Fatigue	·	·	✓
SD	Head discomfort	·	·	✓
SD	Headache	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Office visit	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Vasculitis	·	·	✓
SRO	Bronchitis	·	·	✓
SRO	Bronchospasm	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Increased viscosity of upper respiratory secretion	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Nasal mucosal discolouration	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓

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