6LK-17777-02433

3 vaccinations 11 coded responses 35 check-ins 11 free-text entries 5 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 480 / MI
Registered: 2021-02-11

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-11
Registered in v-safe
2021-02-11
Dose 1 — Pfizer-BioNTech
2021-02-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 1
MedDRA: Arthritis, Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Vaccine activated arthritis symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Pfizer-BioNTech
2021-03-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Injection was to high on shoulder. Almost in bone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Rheumatoid arthritis — Feeling: Good · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Above are RA issues that may or not be caused by vaccine shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Survey response — day 14, dose 2
MedDRA: Blood pressure increased, Renal impairment — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Increase in blood pressure and kidney problems

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Survey response — day 21, dose 2
MedDRA: Pre-existing disease, Rheumatoid arthritis — Feeling: Good · Be unable to do your normal daily activities

Free text: RA flareups

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Survey response — 3 months, dose 2
MedDRA: Colonoscopy, Emergency care, Hospitalisation, Polypectomy, Rectal haemorrhage, Ventricular tachycardia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Uncontrollable bleeding after colonoscopy w/polyp removal. Had ventricular tachycardia event in ER. Spent 10 days in hospital.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-19
Call 1 — Left Voicemail
2021-06-21
Call 2 — Left Voicemail
2021-09-03
Survey response — 6 months, dose 2
MedDRA: Atypical pneumonia, Cardiac disorder — Feeling: Good · 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, Hospitalization

Free text: Heart problem and suspected case of walking pneumonia.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-03
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-07
Call 1 — Left Voicemail
2021-10-02
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-10-07
Survey response — days 1–6 daily, dose 3
MedDRA: Back pain — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Back pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-10
Health check-in — day 7, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-08
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-01
Survey response — 3 months, dose 3
MedDRA: Arthritis, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Arthritis flare ups.

MedDRA releases: 2024-11 · check-in free text available
2022-01-01
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-04
Call successful
Does not wish to fill out VAERS report
2022-04-03
Survey response — 6 months, dose 3
MedDRA: Arthritis, Blood pressure increased, Heart rate irregular, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: High blood pressure, erratic heart rate, strange arthritic attacks. · Healthcare visit (other): Numerous doctor bisits

MedDRA releases: 2024-11 · check-in free text available
2022-04-03
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-06
Call successful
Does not wish to fill out VAERS report
2022-10-02
Survey response — 12 months, dose 3
MedDRA: Arthritis, Cough, Influenza like illness, Pre-existing disease, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Poor · Be unable to do your normal daily activities

Free text: Had arthritis flare day after receiving booster. Then one week later I have flu like symptoms including cough/congestion, chills, sinus congestion with runny nose fluid. Took Covid test - negative.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Pfizer-BioNTech
2	2021-03-04	Pfizer-BioNTech
3	2021-10-02	Pfizer-BioNTech	Flu

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-12

Systemic reaction (other): Vaccine activated arthritis symptoms.

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): Injection was to high on shoulder. Almost in bone.

2021-03-07

Systemic reaction (other): Above are RA issues that may or not be caused by vaccine shot.

Release 5 — day 14, dose 2

2021-03-18

Symptoms: Increase in blood pressure and kidney problems

Release 6 — day 21, dose 2

2021-03-25

Symptoms: RA flareups

Release 8 — 3 months, dose 2

2021-06-04

Symptoms: Uncontrollable bleeding after colonoscopy w/polyp removal. Had ventricular tachycardia event in ER. Spent 10 days in hospital.

Release 9 — 6 months, dose 2

2021-09-03

Symptoms: Heart problem and suspected case of walking pneumonia.

Release 10 — days 1–6 daily, dose 3

2021-10-07

Systemic reaction (other): Back pain

Release 10 — 3 months, dose 3

2022-01-01

Symptoms: Arthritis flare ups.

Release 11 — 6 months, dose 3

2022-04-03

Symptoms: High blood pressure, erratic heart rate, strange arthritic attacks.

Healthcare visit (other): Numerous doctor bisits

Release 12 — 12 months, dose 3

2022-10-02

Symptoms: Had arthritis flare day after receiving booster. Then one week later I have flu like symptoms including cough/congestion, chills, sinus congestion with runny nose fluid. Took Covid test - negative.

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	Arthritis	·	·	✓
SD	Atypical pneumonia	✓	·	✓
SD	Blood pressure increased	✓	✓	✓
SD	Cardiac disorder	✓	·	✓
SD	Colonoscopy	✓	✓	✓
SD	Cough	·	·	✓
SD	Emergency care	✓	✓	✓
SD	Heart rate irregular	·	·	✓
SD	Hospitalisation	✓	✓	✓
SD	Influenza like illness	·	·	✓
SD	Polypectomy	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rectal haemorrhage	✓	✓	✓
SD	Renal impairment	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rheumatoid arthritis	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Ventricular tachycardia	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Back pain	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rheumatoid arthritis	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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