67Z-30449-51089
3 vaccinations
3 coded responses
39 check-ins
3 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 809 / CO
- Registered
- 2021-03-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-12
Registered in v-safe
-
2021-03-12
Dose 1 — Pfizer-BioNTech
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-26
-
2021-04-02
Dose 2 — Pfizer-BioNTech
- 2021-04-02
-
2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-09
- 2021-05-14
- 2021-07-02
- 2021-10-01
-
2021-10-27
Dose 3 — Pfizer-BioNTech
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-11
- 2021-11-17
-
2021-11-24
Survey response — day 28, dose 3MedDRA: Condition aggravated, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: My PAD or claudication in my right leg came back one week after receiving my booster vaccine (11/3). · Healthcare visit (other): Doctors officeMedDRA releases: 2024-11 · check-in free text available
-
2021-11-24
Report sent to call center — day 28, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-12-01
- 2021-12-08
- 2022-01-17
-
2022-01-21
Call successfulDoes not wish to fill out VAERS report
-
2022-01-26
Survey response — 3 months, dose 3MedDRA: Angioplasty, Atherectomy, Condition aggravated, Pre-existing disease, Stent placement — Feeling: Good · Get care from a doctor or other healthcare professional · HospitalizationFree text: Was diagnosed with PAD in my right femoral artery, which in itself is not new but reoccurred in Nov 21. In Dec 21 had a angiogram, angioplasty and atherectomy and stent placement. So far I'm good since those procedures.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-26
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
-
2022-01-28
Call successfulDoes not wish to fill out VAERS report
- 2022-04-27
-
2022-10-27
Survey response — 12 months, dose 3MedDRA: Condition aggravated, Gastrointestinal disorder, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Gastrointestinal issues that is being treated. Return of PAD in right femoral / popliteal artery.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-27
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-10-28
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 | 2021-03-12 | Pfizer-BioNTech | |
| 2 | 2021-04-02 | Pfizer-BioNTech | |
| 3 | 2021-10-27 | Pfizer-BioNTech | No |
Call center
3 call center cases
3 successful
Free text
Release 10 — day 28, dose 3
Symptoms: My PAD or claudication in my right leg came back one week after receiving my booster vaccine (11/3).
Healthcare visit (other): Doctors office
Release 11 — 3 months, dose 3
Symptoms: Was diagnosed with PAD in my right femoral artery, which in itself is not new but reoccurred in Nov 21. In Dec 21 had a angiogram, angioplasty and atherectomy and stent placement. So far I'm good since those procedures.
Release 12 — 12 months, dose 3
Symptoms: Gastrointestinal issues that is being treated. Return of PAD in right femoral / popliteal artery.
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 | Angioplasty | · | · | ✓ |
| SD | Atherectomy | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Stent placement | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release