6NY-21513-83817

5 vaccinations 16 coded responses 57 check-ins 15 free-text entries 3 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 972 / OR
Registered: 2021-03-28

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-03-28
Registered in v-safe
2021-03-28
Dose 1 — Pfizer-BioNTech
2021-03-28
Survey response — day 0, dose 1
MedDRA: Blood pressure increased, Heart rate increased, Hyperhidrosis, Medical counselling, Office visit, Tinnitus — Feeling: Good · Headache, Muscle or body aches · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Increased heart rate, blood pressure & sweating; brief ringing in right ear · Healthcare visit (other): Nurses tent on site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Report sent to call center — day 0, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-30
Survey response — days 1–6 daily, dose 1
MedDRA: Decreased appetite, Thirst — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Suppressed appetite & thirsty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Survey response — day 7, dose 1
MedDRA: Respiratory tract congestion, Seasonal allergy — Feeling: Good

Free text: Seasonal allergy congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-18
Dose 2 — Pfizer-BioNTech
2021-04-18
Health check-in — day 0, dose 2
Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Intermittent Left inner thigh pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-04-21
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Site: Redness · Headache, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Light cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-25
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site

Adult check-in
2021-05-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-18
Survey response — 3 months, dose 2
MedDRA: Heat stroke, Medical counselling — 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 · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Not related to vaccination according to primary care doctor, but I likely had some exertion heat stroke symptoms for a brief period. · Healthcare visit (other): Lab work/telephone conversation

MedDRA releases: 2024-11 · check-in free text available
2021-07-18
Report sent to call center — 3 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

1 call case(s)
2021-07-24
Call successful
Participant prefers to complete VAERS report online
2021-10-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-18
Dose 3 — Pfizer-BioNTech
2021-10-18
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-10-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-10-21
Survey response — days 1–6 daily, dose 3
MedDRA: Hypoacusis — Feeling: Fair · Site: Pain

Free text: Hearing different

MedDRA releases: 2024-11 · check-in free text available
2021-10-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-25
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-08
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-15
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-23
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-04
Dose 4 — Pfizer-BioNTech
2022-04-05
Survey response — days 1–6 daily, dose 4
MedDRA: Abdominal pain upper — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Upper left side intestinal pain (sporadic)

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2022-04-07
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-08
Survey response — days 1–6 daily, dose 4
MedDRA: Respiratory tract congestion — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Congestion likely to change in weather

MedDRA releases: 2024-11 · check-in free text available
2022-04-10
Survey response — days 1–6 daily, dose 4
MedDRA: Respiratory tract congestion — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Congestion

MedDRA releases: 2024-11 · check-in free text available
2022-04-11
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-20
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-04-25
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-02
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-09
Survey response — day 35, dose 4
MedDRA: Oropharyngeal pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sore throat at times

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-04
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-03
Survey response — 6 months, dose 4
MedDRA: Neuropathy peripheral — Feeling: Fair · Be unable to do your normal daily activities

Free text: Right hand neuropathy

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Dose 5 — Pfizer-BioNTech
2022-10-31
Survey response — days 1–6 daily, dose 5
MedDRA: Pre-existing disease — Feeling: Poor · Headache, Joint pains, Muscle or body aches · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sinus adjustment to changing Fall local weather conditions

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Survey response — day 7, dose 5
MedDRA: Unevaluable event — Feeling: Poor · Muscle or body aches · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: ADAPTATION COMING ALONG

MedDRA releases: 2024-11 · check-in free text available
2022-11-08
Survey response — day 14, dose 5
MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Continued congestion with intermittent sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-11-16
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-23
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-29
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-12-06
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-01-25
Survey response — 3 months, dose 5
MedDRA: Cough, Fatigue, Headache, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-28	Pfizer-BioNTech
2	2021-04-18	Pfizer-BioNTech
3	2021-10-18	Pfizer-BioNTech	No
4	2022-04-04	Pfizer-BioNTech	No
5	2022-10-25	Pfizer-BioNTech	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-03-28

Systemic reaction (other): Increased heart rate, blood pressure & sweating; brief ringing in right ear

Healthcare visit (other): Nurses tent on site

Release 6 — days 1–6 daily, dose 1

2021-03-30

Systemic reaction (other): Suppressed appetite & thirsty

Release 6 — day 7, dose 1

2021-04-04

Systemic reaction (other): Seasonal allergy congestion

Release 7 — days 1–6 daily, dose 2

2021-04-19

Systemic reaction (other): Intermittent Left inner thigh pain

2021-04-23

Systemic reaction (other): Light cough

Release 9 — 3 months, dose 2

2021-07-18

Symptoms: Not related to vaccination according to primary care doctor, but I likely had some exertion heat stroke symptoms for a brief period.

Healthcare visit (other): Lab work/telephone conversation

Release 10 — days 1–6 daily, dose 3

2021-10-21

Systemic reaction (other): Hearing different

Release 11 — days 1–6 daily, dose 4

2022-04-05

Systemic reaction (other): Upper left side intestinal pain (sporadic)

2022-04-08

Systemic reaction (other): Congestion likely to change in weather

2022-04-10

Systemic reaction (other): Congestion

Release 11 — day 35, dose 4

2022-05-09

Symptoms: Sore throat at times

Release 12 — 6 months, dose 4

2022-10-03

Symptoms: Right hand neuropathy

Release 12 — days 1–6 daily, dose 5

2022-10-31

Systemic reaction (other): Sinus adjustment to changing Fall local weather conditions

Release 12 — day 7, dose 5

2022-11-01

Systemic reaction (other): ADAPTATION COMING ALONG

Release 12 — day 14, dose 5

2022-11-08

Symptoms: Continued congestion with intermittent sore throat

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	✓	✓	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Heat stroke	·	·	✓
SD	Neuropathy peripheral	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Abdominal pain upper	·	·	✓
SRO	Blood pressure increased	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Hypoacusis	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	·	·	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Seasonal allergy	✓	✓	✓
SRO	Thirst	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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