55C-24531-11068
5 vaccinations
7 coded responses
65 check-ins
6 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 56-60
- ZIP prefix
- 945 / CA
- Registered
- 2021-02-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-17
Dose 1 — Moderna
-
2021-02-18
Registered in v-safe
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-03-03
- 2021-03-10
-
2021-03-17
Dose 2 — Moderna
- 2021-03-17
-
2021-03-18
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to workAdult check-in
- 2021-03-19
-
2021-03-20
Survey response — days 1–6 daily, dose 2MedDRA: Discomfort, Office visit, Periorbital swelling — Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Swelling around left eye. it started the evening I was vaccinated the second time but I wasn't thinking it was related. On March 19th two days after the shot I visited my eye doctor. He examined my eye and said it was fine he doesn't know but he is wondering if the puffiness might be related to the shot. I'm using warm compresses and I drops to relieve the discomfort · Healthcare visit (other): Office visit to eye doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-20
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-21
Survey response — days 1–6 daily, dose 2MedDRA: Eye pain — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Eye area seems to he improving from yesterday. It no longer hurts to blink my left eye however I do notice around this around the eye on my cheek and above my eyelid but it appears to be getting betterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-22
Survey response — days 1–6 daily, dose 2MedDRA: Periorbital swelling — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Puffiness around left eye is diminishedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-23
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-06-16
- 2021-09-15
-
2021-10-29
Dose 3 — Pfizer-BioNTech
- 2021-10-29
-
2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Irritability — Feeling: Fair · Site: Pain · Muscle or body achesFree text: IrritableMedDRA releases: 2024-11 · check-in free text available
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-10
- 2022-01-03
-
2022-01-28
Survey response — 3 months, dose 3MedDRA: COVID-19, Chest pain, Nasopharyngitis — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Covid positive 1/13/22. Cold like symptoms and chest pain. No feverMedDRA releases: 2024-11 · check-in free text available
-
2022-01-28
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-01-31
Call successfulParticipant prefers to complete VAERS report online
- 2022-04-29
-
2022-05-20
Dose 4 — Pfizer-BioNTech
- 2022-05-20
- 2022-05-21
- 2022-05-22
- 2022-05-23
- 2022-05-24
- 2022-05-25
- 2022-05-26
- 2022-05-28
-
2022-06-03
Survey response — day 14, dose 4MedDRA: No adverse event — Feeling: GoodFree text: Feeling fineMedDRA releases: 2024-11 · check-in free text available
- 2022-06-10
- 2022-06-17
- 2022-06-24
- 2022-07-01
- 2022-08-19
-
2022-10-15
Dose 5 — Pfizer-BioNTech
-
2022-10-16
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-10-17
- 2022-10-19
- 2022-10-20
- 2022-10-21
- 2022-10-22
- 2022-10-29
- 2022-11-12
- 2022-11-19
- 2022-11-26
- 2023-01-14
-
2023-04-17
Survey response — 6 months, dose 5MedDRA: Limb operation — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-04-17
Report sent to call center — 6 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-04-19
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2023-04-19
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-17 | Moderna | |
| 2 | 2021-03-17 | Moderna | |
| 3 | 2021-10-29 | Pfizer-BioNTech | No |
| 4 | 2022-05-20 | Pfizer-BioNTech | No |
| 5 | 2022-10-15 | Pfizer-BioNTech | No |
Call center
3 call center cases
3 successful
1 wait over 3 months for a first call
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Swelling around left eye. it started the evening I was vaccinated the second time but I wasn't thinking it was related. On March 19th two days after the shot I visited my eye doctor. He examined my eye and said it was fine he doesn't know but he is wondering if the puffiness might be related to the shot. I'm using warm compresses and I drops to relieve the discomfort
Healthcare visit (other): Office visit to eye doctor
Systemic reaction (other): Eye area seems to he improving from yesterday. It no longer hurts to blink my left eye however I do notice around this around the eye on my cheek and above my eyelid but it appears to be getting better
Systemic reaction (other): Puffiness around left eye is diminished
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Irritable
Release 11 — 3 months, dose 3
Symptoms: Covid positive 1/13/22. Cold like symptoms and chest pain. No fever
Release 11 — day 14, dose 4
Symptoms: Feeling fine
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 | ✓ | ✓ | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Limb operation | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | No adverse event | · | · | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Irritability | · | · | ✓ |
| SRO | Office visit | ✓ | ✓ | ✓ |
| SRO | Periorbital swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release