5SZ-17266-01095

2 vaccinations 10 coded responses 16 check-ins 10 free-text entries 7 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 379 / TN
Registered: 2021-04-01

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

2021-03-11
Dose 1 — Pfizer-BioNTech
2021-04-01
Registered in v-safe
2021-04-01
Dose 2 — Pfizer-BioNTech
2021-04-01
Survey response — day 0, dose 2
MedDRA: Malaise, Pre-existing disease — Feeling: Good

Free text: The first vaccine made me sick for almost 2 weeks. I have had COVID-19 previously.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Sleep disorder — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Terrible headache for 24 hours, preventing good sleep.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Deep vein thrombosis, Emergency care — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Thrombosus of the popiteal vein in the left calve. According to the emergency room doctors.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Deep vein thrombosis — Feeling: Fair · Headache, Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: The popliteal thrombosis apparently hasn't killed me yet, but it hurts.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Deep vein thrombosis — Feeling: Fair · Headache, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Still recovering from the popliteal vein thrombisus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Deep vein thrombosis — Feeling: Fair · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Still recovering from the Deep Vein Thrombosis (DVT)).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-08
Survey response — day 7, dose 2
MedDRA: Deep vein thrombosis — Feeling: Fair · Muscle or body aches · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Still recovering from the DVT clot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — day 7, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-27
Survey response — day 21, dose 2
MedDRA: Deep vein thrombosis, Hospitalisation, Thrombosis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Recovering from the CLOT, the Deep Vein Thrombosis (DVT), which sent me to the hospital after the vaccine, and apparently could have killed me. But you guys obviously don't care, so I don't know why I'm bothering to write this.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Report sent to call center — day 21, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Health check-in — day 28, dose 2
Feeling: Poor

Adult check-in
2021-05-06
Health check-in — day 35, dose 2
Feeling: Poor

Adult check-in
2021-05-13
Survey response — day 42, dose 2
MedDRA: Deep vein thrombosis, Pain, Pain in extremity — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: The vaccine induced DVT clot in my leg has started hurting and stinging again.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-30
Call successful
Does not wish to fill out VAERS report
2022-04-01
Survey response — 12 months, dose 2
MedDRA: Cardiac disorder, Unevaluable event — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Cardiac problems · Healthcare visit (other): Testing

MedDRA releases: 2024-11 · check-in free text available
2022-04-01
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-07
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Pfizer-BioNTech
2	2021-04-01	Pfizer-BioNTech

Call center

7 call center cases

7 successful

See the call center timeline

Free text

Release 6 — day 0, dose 2

2021-04-01

Systemic reaction (other): The first vaccine made me sick for almost 2 weeks. I have had COVID-19 previously.

Release 6 — days 1–6 daily, dose 2

2021-04-03

Systemic reaction (other): Terrible headache for 24 hours, preventing good sleep.

2021-04-04

Systemic reaction (other): Thrombosus of the popiteal vein in the left calve. According to the emergency room doctors.

2021-04-05

Systemic reaction (other): The popliteal thrombosis apparently hasn't killed me yet, but it hurts.

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Still recovering from the popliteal vein thrombisus

2021-04-07

Systemic reaction (other): Still recovering from the Deep Vein Thrombosis (DVT)).

Release 7 — day 7, dose 2

2021-04-08

Systemic reaction (other): Still recovering from the DVT clot.

Release 8 — day 21, dose 2

2021-04-27

Symptoms: Recovering from the CLOT, the Deep Vein Thrombosis (DVT), which sent me to the hospital after the vaccine, and apparently could have killed me. But you guys obviously don't care, so I don't know why I'm bothering to write this.

Release 8 — day 42, dose 2

2021-05-13

Symptoms: The vaccine induced DVT clot in my leg has started hurting and stinging again.

Release 11 — 12 months, dose 2

2022-04-01

Symptoms: Cardiac problems

Healthcare visit (other): Testing

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	Cardiac disorder	·	·	✓
SD	Deep vein thrombosis	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Thrombosis	✓	✓	✓
SRO	Deep vein thrombosis	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓

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