73D-16225-17360
3 vaccinations
3 coded responses
8 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 294 / SC
- Registered
- 2021-10-15
- Relationship
- Adult relative or friend
- Guardian
- 6SA-75146-21904
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-05
Dose 1 — Pfizer-BioNTech
-
2021-02-26
Dose 2 — Pfizer-BioNTech
-
2021-09-29
Dose 3 — Pfizer-BioNTech
-
2021-10-15
Registered in v-safe
-
2021-10-15
Survey response — day 14, dose 3, dependentMedDRA: Emergency care, Headache, Immunisation reaction, Musculoskeletal stiffness, Neck pain — Feeling: Poor · Be unable to do their normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Pounding headache, extreme and painful stiff neck, pulse rate over 100. 4 visits to ER. Diagnosed as adverse effect to booster.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-15
Report sent to call center — day 14, dose 3, dependentBe unable to do their normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2021-10-18
Call successfulParticipant prefers to complete VAERS report online
- 2021-10-21
-
2021-10-27
Survey response — day 28, dose 3, dependentMedDRA: Palpitations — Feeling: FairFree text: Heart palpitations.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-03
-
2021-11-11
Survey response — day 42, dose 3, dependentMedDRA: Musculoskeletal stiffness, Palpitations — Feeling: PoorFree text: Symptoms: stiff neck came back along with racing heartbeat. He is retired so the following questions do not pertain to him.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-30
- 2022-03-30
- 2022-09-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Pfizer-BioNTech | No |
| 2 | 2021-02-26 | Pfizer-BioNTech | No |
| 3 | 2021-09-29 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 10 — day 14, dose 3, dependent
Symptoms: Pounding headache, extreme and painful stiff neck, pulse rate over 100. 4 visits to ER. Diagnosed as adverse effect to booster.
Release 10 — day 28, dose 3, dependent
Symptoms: Heart palpitations.
Release 10 — day 42, dose 3, dependent
Symptoms: Symptoms: stiff neck came back along with racing heartbeat. He is retired so the following questions do not pertain to him.
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 |
|---|---|---|---|---|
| SD | Emergency care | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Immunisation reaction | · | · | ✓ |
| SD | Musculoskeletal stiffness | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Palpitations | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release