4MH-15435-43476
4 vaccinations
7 coded responses
39 check-ins
7 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 890 / NV
- Registered
- 2021-03-19
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-25
Dose 1 — Pfizer-BioNTech
-
2021-03-19
Registered in v-safe
-
2021-03-19
Dose 2 — Pfizer-BioNTech
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
-
2021-04-30
Survey response — day 42, dose 2MedDRA: Herpes zoster, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I had shingles 2 years ago and it may be coincidental but around the time of my first shot I had a reoccurrence and it is still present now. When I went to see my doctor today he was not sure if they could be related.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-30
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-18
Survey response — 3 months, dose 2MedDRA: Musculoskeletal pain, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: Pain in the right buttock by the piriformis muscle that started at about the same time as first vaccination. Not sure if related. · Healthcare visit (other): Physical therapyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-18
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-24
Call successfulParticipant prefers to complete VAERS report online
-
2021-06-24
Call successfulParticipant prefers to complete VAERS report online
- 2021-09-19
-
2021-09-30
Dose 3 — Pfizer-BioNTech
- 2021-09-30
- 2021-10-01
- 2021-10-02
- 2021-10-03
-
2021-10-04
Survey response — days 1–6 daily, dose 3MedDRA: Pre-existing disease, Rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Re emergence of a shingle type rash above the hairline in the groin areaMedDRA releases: 2024-11 · check-in free text available
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2021-10-05
Survey response — days 1–6 daily, dose 3MedDRA: Rash, Rash vesicular — Feeling: GoodFree text: Shingle like rash in the groin area above hairlineMedDRA releases: 2024-11 · check-in free text available
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2021-10-06
Survey response — days 1–6 daily, dose 3MedDRA: Rash, Rash vesicular — Feeling: GoodFree text: Shingle like rash in the groin area above the hairlineMedDRA releases: 2024-11 · check-in free text available
-
2021-10-07
Survey response — day 7, dose 3MedDRA: Rash, Rash vesicular — Feeling: GoodFree text: Shingle like rash in the groin area above the hairlineMedDRA releases: 2024-11 · check-in free text available
- 2021-10-14
- 2021-10-22
- 2021-10-28
- 2021-11-05
- 2021-11-11
- 2021-12-30
- 2022-03-31
-
2022-04-04
Dose 4 — Moderna
- 2022-04-14
- 2022-04-18
- 2022-04-25
- 2022-05-02
- 2022-05-09
- 2022-05-16
-
2022-07-04
Survey response — 3 months, dose 4MedDRA: Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative, SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Tested positive for Covid 19 on Jun 15. Had very bad sore throat for 3 days and low grade fever of about 100.4. Was prescribed Paxlovid and tested negative on Jun 23rd.MedDRA releases: 2024-11 · check-in free text available
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2022-07-04
Report sent to call center — 3 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-07-05
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-03
- 2023-04-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Pfizer-BioNTech | |
| 2 | 2021-03-19 | Pfizer-BioNTech | |
| 3 | 2021-09-30 | Pfizer-BioNTech | No |
| 4 | 2022-04-04 | Moderna | No |
Call center
3 call center cases
3 successful
Free text
Release 8 — day 42, dose 2
Symptoms: I had shingles 2 years ago and it may be coincidental but around the time of my first shot I had a reoccurrence and it is still present now. When I went to see my doctor today he was not sure if they could be related.
Release 9 — 3 months, dose 2
Symptoms: Pain in the right buttock by the piriformis muscle that started at about the same time as first vaccination. Not sure if related.
Healthcare visit (other): Physical therapy
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Re emergence of a shingle type rash above the hairline in the groin area
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Shingle like rash in the groin area above hairline
Systemic reaction (other): Shingle like rash in the groin area above the hairline
Release 10 — day 7, dose 3
Systemic reaction (other): Shingle like rash in the groin area above the hairline
Release 12 — 3 months, dose 4
Symptoms: Tested positive for Covid 19 on Jun 15. Had very bad sore throat for 3 days and low grade fever of about 100.4. Was prescribed Paxlovid and tested negative on Jun 23rd.
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 | Physiotherapy | ✓ | ✓ | ✓ |
| SD | Herpes zoster | ✓ | ✓ | ✓ |
| SD | Musculoskeletal pain | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Rash vesicular | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release