XY7-32291-63905

4 vaccinations 9 coded responses 43 check-ins 9 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 986 / WA
Registered: 2021-01-28

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Pfizer-BioNTech
2021-01-28
Health check-in — 0 day, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — 7 day, dose 1
Feeling: Fair · Joint pains, Muscle or body aches · Be unable to work

Adult check-in
2021-02-18
Dose 2 — Pfizer-BioNTech
2021-02-18
Health check-in — 0 day, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose increased, Diabetes mellitus, Pre-existing disease — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-25
Health check-in — 7 day, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — 3 month, dose 2
Feeling: Fair

Adult check-in
2021-08-21
Survey response — 6 month, dose 2
MedDRA: Office visit, Urinary tract infection — 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 · Emergency room or emergency department visit

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-21
Report sent to call center — 6 month, 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)
2021-08-26
Call 1 — Left Voicemail
2021-09-29
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-09-29
Health check-in — 0 day, dose 3
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-09-30
Survey response — days 1–6 daily, dose 3
MedDRA: Blood glucose increased, Pain — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-10-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

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

Adult check-in
2021-10-13
Survey response — 14 day, dose 3
MedDRA: Arthralgia, Fatigue — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-10-21
Health check-in — 21 day, dose 3
Feeling: Fair

Adult check-in
2021-10-28
Survey response — 28 day, dose 3
MedDRA: Arthralgia, Fatigue, Pain, Poor quality sleep, Pre-existing disease — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-11-03
Health check-in — 35 day, dose 3
Feeling: Fair

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

Adult check-in
2021-12-29
Health check-in — 3 month, dose 3
Feeling: Fair

Adult check-in
2022-03-30
Survey response — 6 month, dose 3
MedDRA: Cystitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2022-03-30
Report sent to call center — 6 month, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-31
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-10
Dose 4 — Pfizer-BioNTech
2022-04-14
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-04-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-04-17
Survey response — 7 day, dose 4
MedDRA: Pre-existing disease, Rheumatoid arthritis — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-04-24
Health check-in — 14 day, dose 4
Feeling: Fair

Adult check-in
2022-05-02
Survey response — 21 day, dose 4
MedDRA: Nasopharyngitis — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-05-09
Health check-in — 28 day, dose 4
Feeling: Fair

Adult check-in
2022-05-15
Health check-in — 35 day, dose 4
Feeling: Fair

Adult check-in
2022-05-23
Survey response — 42 day, dose 4
MedDRA: Arthralgia, Fatigue, Joint swelling, Malaise — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-07-10
Health check-in — 3 month, dose 4
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Pfizer-BioNTech
2	2021-02-18	Pfizer-BioNTech
3	2021-09-29	Pfizer-BioNTech	Flu
4	2022-04-10	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-21	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-30	Successful 2022-03-31	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 4

Systemic reaction (other): Im diabetic and my blood sugar is very high today.

Release 9

Symptoms: UTI - serious

Healthcare visit (other): MD visit

Systemic reaction (other): High blood sugar and all over body aches

Release 10

Symptoms: Very painful joints and higher level of fatigue.

Symptoms: Increased Fatigue, poor sleep, joint pain, body pain

Release 11

Symptoms: Bladder infection

Systemic reaction (other): (b)(6) has RA and he always has sore joints and muscles And these shots make it worse for awhile

redacted (b)(6)

Symptoms: Cold symptoms

Symptoms: Joint swelling and joint pain and general fatigue and feeling unwell.

Free-text releases are not linked to a specific 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	Arthralgia	·	·	✓
SD	Cystitis	·	·	✓
SD	Fatigue	·	·	✓
SD	Joint swelling	·	·	✓
SD	Malaise	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain	·	·	✓
SD	Poor quality sleep	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Urinary tract infection	✓	·	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Diabetes mellitus	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rheumatoid arthritis	·	·	✓

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