6LD-22513-33930

4 vaccinations 11 coded responses 43 check-ins 10 free-text entries 6 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 257 / WV
Registered: 2021-01-07

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

2021-01-05
Dose 1 — Pfizer-BioNTech
2021-01-07
Registered in v-safe
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Vertigo — Feeling: Good · Headache

Free text: Slightly vertiginous

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-01-09
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Spacey

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-25
Dose 2 — Pfizer-BioNTech
2021-01-26
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Slightly "spacey" as before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Dizzy (known h/o veztibulitis)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Nausea, Abdominal pain

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-01
Survey response — day 35, dose 2
MedDRA: Musculoskeletal stiffness — Feeling: Fair

Free text: Stiff neck.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Dose 3 — Pfizer-BioNTech
2021-09-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-01
Survey response — days 1–6 daily, dose 3
MedDRA: Adverse reaction — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: I think this is the flu vaccine related symptoms.

MedDRA releases: 2024-11 · check-in free text available
2021-10-02
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease, Sciatica — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Exacerbated sciatic pain.

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-08
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-13
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-10-20
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-10-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-04
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-12
Survey response — day 42, dose 3
MedDRA: Condition aggravated, Medical counselling, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have a baseline neuropathy. It has been worse recently. · Healthcare visit (other): Informal telephone call.

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-15
Call successful
Participant prefers to complete VAERS report online
2021-12-30
Survey response — 3 months, dose 3
MedDRA: Accident, Rotator cuff syndrome, Tendon rupture, Unevaluable event — Feeling: Fair · 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

Free text: Symptoms: Diagnosed with ruptured tendon in my shoulder and torn rotator cuff. I believe this was related to an accident in September. · Healthcare visit (other): Surgery in about 2 weeks.

MedDRA releases: 2024-11 · check-in free text available
2021-12-30
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-11
Call 1 — Left Voicemail
2022-01-12
Call successful
Not applicable - Accidental Reporting
2022-03-30
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-11
Dose 4 — Pfizer-BioNTech
2022-05-15
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-18
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-25
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-17
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-10
Survey response — 3 months, dose 4
MedDRA: COVID-19 — Feeling: Good · 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

Free text: Covid 7/3-7/18. Moderate to severe. Pulmicort x 10 days.

MedDRA releases: 2024-11 · check-in free text available
2022-08-10
Report sent to call center — 3 months, dose 4
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 · 1 call case(s)
2022-08-11
Call successful
Does not wish to fill out VAERS report
2023-05-11
Survey response — 12 months, dose 4
MedDRA: Arteriospasm coronary, Coronary arterial stent insertion, Coronary artery stenosis — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

MedDRA releases: 2024-11
2023-05-11
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2023-05-12
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Pfizer-BioNTech
2	2021-01-25	Pfizer-BioNTech
3	2021-09-29	Pfizer-BioNTech	No
4	2022-05-11	Pfizer-BioNTech	No

Call center

6 call center cases

3 successful · 1 unsuccessful · 2 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-07

Systemic reaction (other): Slightly vertiginous

2021-01-10

Systemic reaction (other): Spacey

Release 2 — days 1–6 daily, dose 2

2021-01-26

Systemic reaction (other): Slightly "spacey" as before.

2021-01-27

Systemic reaction (other): Dizzy (known h/o veztibulitis)

Release 4 — day 35, dose 2

2021-03-01

Symptoms: Stiff neck.

Release 9 — days 1–6 daily, dose 3

2021-10-01

Systemic reaction (other): I think this is the flu vaccine related symptoms.

2021-10-02

Systemic reaction (other): Exacerbated sciatic pain.

Release 10 — day 42, dose 3

2021-11-12

Symptoms: I have a baseline neuropathy. It has been worse recently.

Healthcare visit (other): Informal telephone call.

Release 10 — 3 months, dose 3

2021-12-30

Symptoms: Diagnosed with ruptured tendon in my shoulder and torn rotator cuff. I believe this was related to an accident in September.

Healthcare visit (other): Surgery in about 2 weeks.

Release 12 — 3 months, dose 4

2022-08-10

Symptoms: Covid 7/3-7/18. Moderate to severe. Pulmicort x 10 days.

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	Unevaluable event	·	·	✓
SD	Accident	·	·	✓
SD	Arteriospasm coronary	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Coronary arterial stent insertion	·	·	✓
SD	Coronary artery stenosis	·	·	✓
SD	COVID-19	·	·	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Rotator cuff syndrome	·	·	✓
SD	Tendon rupture	·	·	✓
SRO	Adverse reaction	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Pre-existing disease	·	·	✓
SRO	Sciatica	·	·	✓
SRO	Vertigo	✓	✓	✓

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