4J6-27523-90003
5 vaccinations
6 coded responses
58 check-ins
6 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 481 / MI
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-20
Registered in v-safe
-
2021-01-20
Dose 1 — Pfizer-BioNTech
- 2021-01-20
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-24
-
2021-01-25
Survey response — days 1–6 daily, dose 1MedDRA: Hyperhidrosis — Feeling: Good · Muscle or body achesFree text: Slight sweating spell, muscle spasms overnight 1-2 hrMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-26
- 2021-01-28
- 2021-02-03
-
2021-02-10
Dose 2 — Pfizer-BioNTech
- 2021-02-10
- 2021-02-11
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
-
2021-02-24
Survey response — day 14, dose 2MedDRA: Pruritus, Rash — Feeling: GoodFree text: Rash, intense itching on trunkMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-03
Survey response — day 21, dose 2MedDRA: Cough, Lymphadenopathy, Pruritus — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Itchy skin, site of which moves around ( hands, forearms, side, back. Looks allergic. Slightly swollen lymph glands (rt side of neck), New cough.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-03
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-10
Survey response — day 28, dose 2MedDRA: Pruritus, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Hives on arms, general itchiness gor about 2 weeks.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-10
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-17
Survey response — day 35, dose 2MedDRA: Emergency care, Lip swelling, Pharyngeal swelling, Pruritus, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Many hives, swelling in lips, throat. Ended up in ER. Hives began few weeks ago. I had generalized itching after shot #2. Then I had to d/c routine antihistamine so could do allergy scratch test and the # of hives increased dramatically.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-17
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-24
- 2021-05-12
- 2021-08-11
-
2021-08-26
Call successfulReported to VAERS voluntarily prior to GDIT contact
-
2021-10-01
Dose 3 — Pfizer-BioNTech
- 2021-10-01
- 2021-10-02
- 2021-10-03
- 2021-10-04
- 2021-10-05
- 2021-10-07
- 2021-10-08
- 2021-10-17
- 2021-10-22
- 2021-10-29
-
2021-11-05
Survey response — day 35, dose 3MedDRA: Pain in extremity, Peripheral swelling — Feeling: GoodFree text: Leg pains near groin, some atypical swelling of left calf x 2 daysMedDRA releases: 2024-11 · check-in free text available
- 2021-11-12
- 2021-12-31
- 2022-04-01
-
2022-04-06
Dose 4 — Moderna
- 2022-04-15
- 2022-04-20
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-07-06
-
2022-09-19
Dose 5 — Pfizer-BioNTech
-
2022-09-20
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Itching · Joint pains, Muscle or body achesAdult check-in
-
2022-09-21
Health check-in — days 1–6 daily, dose 5Feeling: Good · Joint pains, Muscle or body achesAdult check-in
- 2022-09-22
- 2022-09-23
- 2022-09-24
- 2022-09-25
- 2022-09-26
- 2022-10-03
- 2022-10-13
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-12-20
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Pfizer-BioNTech | |
| 2 | 2021-02-10 | Pfizer-BioNTech | |
| 3 | 2021-10-01 | Pfizer-BioNTech | No |
| 4 | 2022-04-06 | Moderna | No |
| 5 | 2022-09-19 | Pfizer-BioNTech | No |
Call center
3 call center cases
3 successful
VAERS report filed, before or during a call: 3
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Slight sweating spell, muscle spasms overnight 1-2 hr
Release 4 — day 14, dose 2
Symptoms: Rash, intense itching on trunk
Release 5 — day 21, dose 2
Symptoms: Itchy skin, site of which moves around ( hands, forearms, side, back. Looks allergic. Slightly swollen lymph glands (rt side of neck), New cough.
Release 5 — day 28, dose 2
Symptoms: Hives on arms, general itchiness gor about 2 weeks.
Release 5 — day 35, dose 2
Symptoms: Many hives, swelling in lips, throat. Ended up in ER. Hives began few weeks ago. I had generalized itching after shot #2. Then I had to d/c routine antihistamine so could do allergy scratch test and the # of hives increased dramatically.
Release 10 — day 35, dose 3
Symptoms: Leg pains near groin, some atypical swelling of left calf x 2 days
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 | Cough | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Lip swelling | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Peripheral swelling | · | · | ✓ |
| SD | Pharyngeal swelling | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release