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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

  1. 2021-03-16
    Registered in v-safe
  2. 2021-03-16
    Dose 1 — Pfizer-BioNTech
  3. 2021-03-16
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-03-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-03-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-25
    Survey response — day 7, dose 1
    MedDRA: Postoperative wound infection, Pre-existing disease — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free 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
  9. 2021-03-25
    Report sent to call center — day 7, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-04-01
    Survey response — day 14, dose 1
    MedDRA: 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 visit
    Free 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 implant
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-01
    Report sent to call center — day 14, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  12. 2021-06-07
  13. 2021-06-15
    Survey response — 3 months, dose 1
    MedDRA: 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 visit
    Free 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
  14. 2021-06-15
    Report sent to call center — 3 months, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  15. 2021-06-21
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-03-16Pfizer-BioNTech

Call center

3 call center cases

1 successful · 2 unsuccessful

See the call center timeline

Free text

Release 6 — day 7, dose 1

2021-03-25

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

2021-04-01

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

2021-06-15

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event ✓ ✓ ✓
SDCough ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDMedical device site infection ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDProcedural complication ✓ ✓ ✓
SDRespiratory tract congestion ✓ ✓ ✓
SDThroat irritation ✓ ✓ ✓
SDWound treatment ✓ ✓ ✓
SROPostoperative wound infection ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

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