5AE-25178-18272
1 vaccination
3 coded responses
8 check-ins
3 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 331 / FL
- Registered
- 2021-03-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-16
Registered in v-safe
-
2021-03-16
Dose 1 — Pfizer-BioNTech
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
-
2021-03-25
Survey response — day 7, dose 1MedDRA: Postoperative wound infection, Pre-existing disease — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I think the vaccine had an adverse effect to a procedure that I had done a few days before the vaccine I had an sacral nerve stimulator put on and where though stitches were it got infected can I have a belief or a feeling that this is correlated to the vaccine could you please have someone call me so I can explain better my phone number is(b)(6) and my name is (b)(6)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-25
Report sent to call center — day 7, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-01
Survey response — day 14, dose 1MedDRA: Medical device site infection, Pre-existing disease, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: My sacral nerve stimulator that was implanted a couple of weeks before the vaccine has gotten infected and they might have to remove it I think someone should call me so that youre aware of something like this so it doesnt happens to someone el · Healthcare visit (other): In the next day or so the doctor may hospitalize me to remove the implantMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-07
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2021-06-15
Survey response — 3 months, dose 1MedDRA: Cough, Headache, Procedural complication, Respiratory tract congestion, Throat irritation, Wound treatment — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Coughing itching in the throat congestion, headache headaches and a procedure that I had done got complicated and I need to have daily wound care For the last eight weeks. I am 99% sure that it was a vaccinne [phone]MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-15
Report sent to call center — 3 months, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-06-21
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Pfizer-BioNTech |
Call center
3 call center cases
1 successful · 2 unsuccessful
Free text
Release 6 — day 7, dose 1
Systemic reaction (other): I think the vaccine had an adverse effect to a procedure that I had done a few days before the vaccine I had an sacral nerve stimulator put on and where though stitches were it got infected can I have a belief or a feeling that this is correlated to the vaccine could you please have someone call me so I can explain better my phone number is(b)(6) and my name is (b)(6)
redacted (b)(6)
Release 6 — day 14, dose 1
Symptoms: My sacral nerve stimulator that was implanted a couple of weeks before the vaccine has gotten infected and they might have to remove it I think someone should call me so that youre aware of something like this so it doesnt happens to someone el
Healthcare visit (other): In the next day or so the doctor may hospitalize me to remove the implant
Release 9 — 3 months, dose 1
Symptoms: Coughing itching in the throat congestion, headache headaches and a procedure that I had done got complicated and I need to have daily wound care For the last eight weeks. I am 99% sure that it was a vaccinne [phone]
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Medical device site infection | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Procedural complication | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | Throat irritation | ✓ | ✓ | ✓ |
| SD | Wound treatment | ✓ | ✓ | ✓ |
| SRO | Postoperative wound infection | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release