4CA-29849-31164

3 vaccinations 13 coded responses 34 check-ins 13 free-text entries 2 call cases

Sex: Male
Age at first dose: 26-30
ZIP prefix: 304 / GA
Registered: 2021-01-04

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

Timeline

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

2021-01-04
Registered in v-safe
2021-01-04
Dose 1 — Pfizer-BioNTech
2021-01-04
Survey response — day 0, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Poor · Site: Pain

Free text: I have three autoimmune diseases going untreated. These underlying conditions may skew my responses negatively.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Itching · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-07
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-01-11
Survey response — day 7, dose 1
MedDRA: Insomnia — Feeling: Fair · Fatigue or tiredness

Free text: I seem to be unable to sleep at night. And when i calm sleep it's for no more than three hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Survey response — day 14, dose 1
MedDRA: Abdominal pain upper, Decreased appetite — Feeling: Poor

Free text: Decreased appetite, sharp stabbing stomach pain on eating.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Dose 2 — Pfizer-BioNTech
2021-01-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Decreased appetite, Hallucination, auditory, Influenza like illness, Migraine, Muscle spasms, Pre-existing disease — Feeling: Poor · Site: Pain, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Free text: terror, flu like symptoms, migraines, auditory hallucinations, loss of appetite, muscle spasms, exacerbation of existing conditions

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Confusional state, Fear — Feeling: Fair · Site: Itching · Chills, Headache, Fatigue or tiredness, Abdominal pain

Free text: Terrors, confusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-08
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-15
Survey response — day 21, dose 2
MedDRA: Injection site pain, Tenderness — Feeling: Fair

Free text: My arm has started to hurt at the injection site again. As well, possibly unrelated, my nostrils have become tender.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — day 28, dose 2
MedDRA: Colitis ulcerative, Insomnia, Pain, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: My ulcerative colitis is getting worse. I don't have health insurance anymore. Im in so much pain every day. I can't sleep through the night. I need help that i cannot afford. I don't know what to do.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — day 35, dose 2
MedDRA: Tremor — Feeling: Fair

Free text: My hands wont stop shaking.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — day 42, dose 2
MedDRA: Impaired healing, Scratch, Skin laceration — Feeling: Fair

Free text: My body isn't healing right. Scratches and cuts that i got weeks or months ago still look fresh.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — 3 months, dose 2
Feeling: Poor

Adult check-in
2021-07-26
Survey response — 6 months, dose 2
MedDRA: Chills, Fatigue, Influenza like illness, Pain — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Flu like symptoms, extreme chills, fatigue, full body pain

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-01-25
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2022-01-25
Health check-in — day 0, dose 3
Feeling: Poor · None

Adult check-in
2022-01-25
Survey response — 12 months, dose 2
MedDRA: Acute kidney injury, Acute respiratory failure, COVID-19, Haematochezia, Hyponatraemia, Hypophosphataemia, Hypovolaemic shock, Rectal haemorrhage, Troponin increased — Feeling: Good · 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: Acute respiratory failure w/ hypoxia Covid-19 Hypovolemic shock Rectal bleeding Hematochezia Elevated troponin Acute kidney failure Hyponatremia Hypophosphaternia

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Report sent to call center — 12 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-01-25
Call successful
Completed over the phone
2022-01-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2022-01-27
Survey response — days 1–6 daily, dose 3
MedDRA: Pain in extremity — Feeling: Good

Free text: My toe hurts.

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2022-01-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-02-01
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-02-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-03-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-03-08
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-26
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-07-26
Survey response — 6 months, dose 3
MedDRA: Neoplasm skin — Feeling: Fair

Free text: There's a peculiar growth on my thumb. I had intended to speak with my doctor about it at my most recent appointment, but was not given the opportunity.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Pfizer-BioNTech
2	2021-01-25	Pfizer-BioNTech
3	2022-01-25	Pfizer-BioNTech	Flu

Call center

2 call center cases

1 successful · 1 priority 2/3 (triaged and no follow up)

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 1 — day 0, dose 1

2021-01-04

Systemic reaction (other): I have three autoimmune diseases going untreated. These underlying conditions may skew my responses negatively.

Release 1 — day 7, dose 1

2021-01-11

Systemic reaction (other): I seem to be unable to sleep at night. And when i calm sleep it's for no more than three hours.

Release 2 — day 14, dose 1

2021-01-18

Symptoms: Decreased appetite, sharp stabbing stomach pain on eating.

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): terror, flu like symptoms, migraines, auditory hallucinations, loss of appetite, muscle spasms, exacerbation of existing conditions

2021-01-30

Systemic reaction (other): Terrors, confusion

Release 4 — day 21, dose 2

2021-02-15

Symptoms: My arm has started to hurt at the injection site again. As well, possibly unrelated, my nostrils have become tender.

Release 4 — day 28, dose 2

2021-02-24

Symptoms: My ulcerative colitis is getting worse. I don't have health insurance anymore. Im in so much pain every day. I can't sleep through the night. I need help that i cannot afford. I don't know what to do.

Release 4 — day 35, dose 2

2021-03-01

Symptoms: My hands wont stop shaking.

Release 5 — day 42, dose 2

2021-03-08

Symptoms: My body isn't healing right. Scratches and cuts that i got weeks or months ago still look fresh.

Release 9 — 6 months, dose 2

2021-07-26

Symptoms: Flu like symptoms, extreme chills, fatigue, full body pain

Release 11 — 12 months, dose 2

2022-01-25

Symptoms: Acute respiratory failure w/ hypoxia Covid-19 Hypovolemic shock Rectal bleeding Hematochezia Elevated troponin Acute kidney failure Hyponatremia Hypophosphaternia

Release 11 — days 1–6 daily, dose 3

2022-01-27

Systemic reaction (other): My toe hurts.

Release 12 — 6 months, dose 3

2022-07-26

Symptoms: There's a peculiar growth on my thumb. I had intended to speak with my doctor about it at my most recent appointment, but was not given the opportunity.

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
SD	Abdominal pain upper	✓	✓	✓
SD	Acute kidney injury	·	·	✓
SD	Acute respiratory failure	·	·	✓
SD	Chills	✓	·	✓
SD	Colitis ulcerative	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Decreased appetite	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Haematochezia	·	·	✓
SD	Hyponatraemia	·	·	✓
SD	Hypophosphataemia	·	·	✓
SD	Hypovolaemic shock	·	·	✓
SD	Impaired healing	✓	✓	✓
SD	Influenza like illness	✓	·	✓
SD	Injection site pain	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Neoplasm skin	·	·	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rectal haemorrhage	·	·	✓
SD	Scratch	✓	✓	✓
SD	Skin laceration	✓	✓	✓
SD	Tenderness	✓	✓	✓
SD	Tremor	✓	✓	✓
SD	Troponin increased	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Fear	✓	✓	✓
SRO	Hallucination, auditory	✓	✓	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Pain in extremity	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sleep disorder	○	○	○

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