68X-21210-03564

4 vaccinations 10 coded responses 24 check-ins 10 free-text entries 9 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 404 / KY
Registered: 2021-03-08

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

2021-03-08
Registered in v-safe
2021-03-08
Dose 1 — Pfizer-BioNTech
2021-03-08
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-29
Dose 2 — Pfizer-BioNTech
2021-03-29
Survey response — day 0, dose 2
MedDRA: Pain — Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Injection arm is throbbing. Hurts to raise arm or reach to pick up anything. Very painful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling, Unevaluable event — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Scheduled primary physician visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
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)
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Mobility decreased, Unevaluable event — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · 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

Free text: Systemic reaction (other): Loss of mobility to injection arm · Healthcare visit (other): Rx prescription

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
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)
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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

Free text: On medication due to vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
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)
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · 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

Free text: On anti inflammatory prescription

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
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)
2021-04-05
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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

Adult check-in
2021-04-05
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)
2021-04-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-19
Survey response — day 21, dose 2
MedDRA: Headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — day 28, dose 2
MedDRA: Arthralgia, Loss of personal independence in daily activities, Mobility decreased — Feeling: Poor · 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

Free text: Left shoulder continues to hurt with limited mobility. Unable to work like I did before shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Report sent to call center — day 28, 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)
2021-05-03
Survey response — day 35, dose 2
MedDRA: Mobility decreased — 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: Limited mobility in left shoulder.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — day 35, 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)
2021-05-10
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-10
Call successful
Participant prefers to complete VAERS report online
2021-06-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-27
Survey response — 6 months, dose 2
MedDRA: Dyspnoea exertional, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Shortness of breath walking or climbing stairs. · Healthcare visit (other): In office visit.

MedDRA releases: 2024-11 · check-in free text available
2021-09-27
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-28
Call successful
Participant prefers to complete VAERS report online
2021-12-15
Dose 3 — Pfizer-BioNTech
2022-03-29
Survey response — 12 months, dose 2
MedDRA: Malaise — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: After first booster I've been sick since January 2022.

MedDRA releases: 2024-11 · check-in free text available
2022-03-29
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-03-31
Call 1 — Could Not Reach Participant
2022-04-05
Call 2 — Could Not Reach Participant
2022-09-27
Dose 4 — Pfizer-BioNTech

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Pfizer-BioNTech
2	2021-03-29	Pfizer-BioNTech
3	2021-12-15	Pfizer-BioNTech	No
4	2022-09-27	Pfizer-BioNTech	No

Call center

9 call center cases

8 successful · 1 unsuccessful

See the call center timeline

Free text

Release 6 — day 0, dose 2

2021-03-29

Systemic reaction (other): Injection arm is throbbing. Hurts to raise arm or reach to pick up anything. Very painful.

Release 6 — days 1–6 daily, dose 2

2021-03-31

Healthcare visit (other): Scheduled primary physician visit

2021-04-01

Systemic reaction (other): Loss of mobility to injection arm

Healthcare visit (other): Rx prescription

2021-04-02

Healthcare visit (other): On medication due to vaccination.

2021-04-03

Systemic reaction (other): On anti inflammatory prescription

Release 7 — day 21, dose 2

2021-04-19

Symptoms: Headaches

Release 7 — day 28, dose 2

2021-04-26

Symptoms: Left shoulder continues to hurt with limited mobility. Unable to work like I did before shot.

Release 8 — day 35, dose 2

2021-05-03

Symptoms: Limited mobility in left shoulder.

Release 9 — 6 months, dose 2

2021-09-27

Symptoms: Shortness of breath walking or climbing stairs.

Healthcare visit (other): In office visit.

Release 11 — 12 months, dose 2

2022-03-29

Symptoms: After first booster I've been sick since January 2022.

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	Medical counselling	✓	✓	○
HCVO	Office visit	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Dyspnoea exertional	·	·	✓
SD	Headache	✓	✓	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Malaise	·	·	✓
SD	Mobility decreased	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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