4WN-31535-58808

3 vaccinations 15 coded responses 31 check-ins 14 free-text entries 4 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 940 / CA
Registered: 2021-01-23

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

2021-01-23
Registered in v-safe
2021-01-23
Dose 1 — Pfizer-BioNTech
2021-01-23
Survey response — day 0, dose 1
MedDRA: Therapeutic product effect increased, Therapy change — Feeling: Good · Be unable to do your normal daily activities

Free text: Vaccine amplified pain medication.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Drug interaction — Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Still interferes with morphine where I have taken much less to compensate.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Epistaxis, Rhinorrhoea — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Free text: Runny nose and nose bleeds.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Haemorrhage, Heart rate abnormal — Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Bleeding and abnormal heart beat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — day 7, dose 1
Feeling: Poor · Fever · Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 42, dose 1
Feeling: Fair

Adult check-in
2021-04-24
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-05-25
Dose 2 — Pfizer-BioNTech
2021-05-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-05-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-05-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Abdominal pain

Adult check-in
2021-06-02
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-10
Survey response — day 14, dose 2
MedDRA: Immunisation reaction — Feeling: Poor

Free text: Vaccine is causing my body to metabolize my medications incorrectly. First shot lasted two months, least worse of it, 2nd started it up again which can cause medications to be too much or too little. Opiets and blood pressure effected greatly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-22
Survey response — day 28, dose 2
MedDRA: Metabolic disorder — Feeling: Fair

Free text: Vaccine has caused metabolism to change how my medications effect me, and each day is different.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Survey response — day 42, dose 2
MedDRA: Influenza, Medical counselling, Metabolic disorder, Secretion discharge — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: As stated two weeks ago, vaccine has changed metabolism where medications don't work when sleeping. Waking with flu symptoms nightly gets tiring, and may have contributed to sinus infection right side. Too much mucus production, my opinion led to thi · Healthcare visit (other): Myhealth discussion back and forth. I'm a IHSS caregiver.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-20
Call 2 — Left Voicemail
2021-08-26
Survey response — 3 months, dose 2
MedDRA: Nasopharyngitis — Feeling: Fair

Free text: Cold symptoms

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-25
Survey response — 6 months, dose 2
MedDRA: Flank pain, Haematochezia — Feeling: Poor · 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: Bloody stool and painful right side

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Report sent to call center — 6 months, dose 2
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 · 1 call case(s)
2022-01-17
Call 1 — Could Not Reach Participant
2022-01-20
Call 2 — Could Not Reach Participant
2022-08-05
Dose 3 — Pfizer-BioNTech
2022-08-07
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Just pain in injection area 9 hours after shot. My medication may be masking symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-08-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2022-08-09
Survey response — days 1–6 daily, dose 3
MedDRA: Burning sensation — Feeling: Poor · Fever · Muscle or body aches, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Same as 2nd shot, intestinal burning entire track

MedDRA releases: 2024-11 · check-in free text available
2022-08-10
Survey response — days 1–6 daily, dose 3
MedDRA: Burning sensation, Nausea, Self-medication — Feeling: Good

Free text: To end the 4 day cycle of burning intestines and severe Neusea, take 2 caps pep 3350 powder two hours apart, no more than 4 caps a day. Drink plenty of liquids. This will flush system and stop both Neusea, burning, within 6 hours.

MedDRA releases: 2024-11 · check-in free text available
2022-08-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Abdominal pain

Adult check-in
2022-08-14
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-08-21
Survey response — day 14, dose 3
MedDRA: Gastrointestinal inflammation, Gastrointestinal pain, Illness, Intestinal obstruction, Reaction to previous exposure to any vaccine — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Like last two times, intestines swelled causing blockages, which followed sickness and required 4 caps of Miralax to force a flush to purge system or be in excruciating intestinal pain. Booster was worse than last two times until brought under contro

MedDRA releases: 2024-11 · check-in free text available
2022-08-21
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-08-22
Call 3 — Left Voicemail
2022-08-22
Call X — Left Voicemail
2022-08-22
Call 2 — Left Voicemail
2022-08-29
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-09-04
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-09-12
Survey response — day 35, dose 3
MedDRA: Malaise, Pyrexia — Feeling: Poor

Free text: Don't believe this is cause of shot. I'm just sick with fever and haven't gotten test done yet.

MedDRA releases: 2024-11 · check-in free text available
2023-02-05
Survey response — 6 months, dose 3
MedDRA: COVID-19, Muscle disorder, Office visit, Sensory loss — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-02-05
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-02-06
Call 1 — Left Voicemail
2023-02-06
Call 3 — Left Voicemail
2023-02-06
Call 1 — Left Voicemail
2023-02-06
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-23	Pfizer-BioNTech
2	2021-05-25	Pfizer-BioNTech
3	2022-08-05	Pfizer-BioNTech	No

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-23

Systemic reaction (other): Vaccine amplified pain medication.

Release 2 — days 1–6 daily, dose 1

2021-01-24

Systemic reaction (other): Still interferes with morphine where I have taken much less to compensate.

2021-01-26

Systemic reaction (other): Runny nose and nose bleeds.

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): Bleeding and abnormal heart beat

Release 9 — day 14, dose 2

2021-06-10

Symptoms: Vaccine is causing my body to metabolize my medications incorrectly. First shot lasted two months, least worse of it, 2nd started it up again which can cause medications to be too much or too little. Opiets and blood pressure effected greatly

Release 9 — day 28, dose 2

2021-06-22

Symptoms: Vaccine has caused metabolism to change how my medications effect me, and each day is different.

Release 9 — day 42, dose 2

2021-07-08

Symptoms: As stated two weeks ago, vaccine has changed metabolism where medications don't work when sleeping. Waking with flu symptoms nightly gets tiring, and may have contributed to sinus infection right side. Too much mucus production, my opinion led to thi cut off by CDC

Healthcare visit (other): Myhealth discussion back and forth. I'm a IHSS caregiver.

Release 9 — 3 months, dose 2

2021-08-26

Symptoms: Cold symptoms

Release 10 — 6 months, dose 2

2021-11-25

Symptoms: Bloody stool and painful right side

Release 12 — days 1–6 daily, dose 3

2022-08-07

Systemic reaction (other): Just pain in injection area 9 hours after shot. My medication may be masking symptoms

2022-08-09

Systemic reaction (other): Same as 2nd shot, intestinal burning entire track

2022-08-10

Systemic reaction (other): To end the 4 day cycle of burning intestines and severe Neusea, take 2 caps pep 3350 powder two hours apart, no more than 4 caps a day. Drink plenty of liquids. This will flush system and stop both Neusea, burning, within 6 hours.

Release 12 — day 14, dose 3

2022-08-21

Symptoms: Like last two times, intestines swelled causing blockages, which followed sickness and required 4 caps of Miralax to force a flush to purge system or be in excruciating intestinal pain. Booster was worse than last two times until brought under contro cut off by CDC

Release 12 — day 35, dose 3

2022-09-12

Symptoms: Don't believe this is cause of shot. I'm just sick with fever and haven't gotten test done yet.

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	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
SD	COVID-19	·	·	✓
SD	Flank pain	·	·	✓
SD	Gastrointestinal inflammation	·	·	✓
SD	Gastrointestinal pain	·	·	✓
SD	Haematochezia	·	·	✓
SD	Illness	·	·	✓
SD	Immunisation reaction	✓	✓	✓
SD	Influenza	✓	✓	✓
SD	Intestinal obstruction	·	·	✓
SD	Malaise	·	·	✓
SD	Metabolic disorder	✓	✓	✓
SD	Muscle disorder	·	·	✓
SD	Nasopharyngitis	✓	·	✓
SD	Pyrexia	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	Secretion discharge	✓	✓	✓
SD	Sensory loss	·	·	✓
SRO	Burning sensation	·	·	✓
SRO	Drug interaction	✓	✓	✓
SRO	Epistaxis	✓	✓	✓
SRO	Haemorrhage	✓	✓	✓
SRO	Heart rate abnormal	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Nausea	·	·	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Self-medication	·	·	✓
SRO	Therapeutic product effect increased	✓	·	✓
SRO	Therapy change	○	✓	○

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