Y38-25154-09927
5 vaccinations
14 coded responses
55 check-ins
13 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 934 / CA
- Registered
- 2021-01-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
RGE-86186-45454
Child or adolescent in my care · Male · 2021-07-29
VZF-10683-53768
Child or adolescent in my care · Male · 2021-12-04
UQM-30476-21550
Adult relative or friend · Female · 2021-12-04
Timeline
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2021-01-07
Registered in v-safe
-
2021-01-07
Dose 1 — Pfizer-BioNTech
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-13
-
2021-01-14
Survey response — day 7, dose 1MedDRA: Peripheral swelling, Pruritus — Feeling: Good · Site: Swelling, ItchingFree text: Itching & slight swelling on small portion of left palmMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-21
Survey response — day 14, dose 1MedDRA: Pruritus — Feeling: GoodFree text: Small itchy area on left palm. Mild.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-28
Dose 2 — Pfizer-BioNTech
- 2021-01-28
-
2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-11
- 2021-02-18
- 2021-02-27
- 2021-03-05
- 2021-03-11
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2021-04-29
Survey response — 3 months, dose 2MedDRA: Deafness, Ear pain, Headache, Hypoacusis, Middle ear effusion, Paranasal sinus hypersecretion, Self-medication — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Headaches last 3.5 weeks. Garbled hearing and hearing loss for 1 week. Both middle ears are filled with fluid. Taking Mucinex to drain sinuses for 2 days. Still have headaches and reduced hearing. It is like my head is an echo chamber.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-29
Report sent to call center — 3 months, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-07-29
Survey response — 6 months, dose 2MedDRA: Dizziness, Headache, Hypoacusis, Tinnitus, Vertigo, Vomiting — Feeling: Poor · 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, Outpatient clinic or urgent care clinic visitFree text: Daily headaches. Episodes of lightheartedness that sometimes worsens into vertigo and vomiting. Hearing is sometimes decreased, sometimes garbled, ringing sometimes high pitched, sometimes my head seems to amplify low frequencies.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-07-29
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-08-04
- 2021-08-06
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2021-08-06
Call successfulParticipant prefers to complete VAERS report online
-
2021-09-04
Dose 3 — Pfizer-BioNTech
- 2021-09-28
- 2021-10-03
- 2021-10-09
- 2021-10-16
- 2021-12-04
- 2022-03-05
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2022-04-19
Dose 4 — Moderna
- 2022-04-19
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2022-04-20
Survey response — days 1–6 daily, dose 4MedDRA: Tinnitus — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tirednessFree text: Ringing in earsMedDRA releases: 2024-11 · check-in free text available
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2022-04-21
Survey response — days 1–6 daily, dose 4MedDRA: Tinnitus — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body achesFree text: Ringing in earsMedDRA releases: 2024-11 · check-in free text available
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2022-04-22
Survey response — days 1–6 daily, dose 4MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessFree text: Ear ringingMedDRA releases: 2024-11 · check-in free text available
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2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-07-19
-
2022-09-23
Dose 5 — Pfizer-BioNTech
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2022-09-26
Survey response — days 1–6 daily, dose 5MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Periodic dizzinessMedDRA releases: 2024-11 · check-in free text available
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2022-09-27
Survey response — days 1–6 daily, dose 5MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: DizzinessMedDRA releases: 2024-11 · check-in free text available
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2022-09-28
Survey response — days 1–6 daily, dose 5MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: DizzinessMedDRA releases: 2024-11 · check-in free text available
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2022-09-30
Survey response — day 7, dose 5MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: DizzyMedDRA releases: 2024-11 · check-in free text available
- 2022-10-07
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2022-10-14
Survey response — day 21, dose 5MedDRA: Ear pain, Fatigue, Oropharyngeal pain, Pain, Pain in jaw, Pyrexia — Feeling: PoorFree text: Body aches, tiredness, sore throat, low grade fever, ear pain, jaw painMedDRA releases: 2024-11 · check-in free text available
- 2022-10-23
- 2022-10-29
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2022-11-04
Survey response — day 42, dose 5MedDRA: Cough — Feeling: Poor · Be unable to work or attend schoolFree text: Deep coughMedDRA releases: 2024-11 · check-in free text available
- 2022-12-23
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2023-03-24
Survey response — 6 months, dose 5MedDRA: COVID-19 — 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 visitMedDRA releases: 2024-11
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2023-03-24
Report sent to call center — 6 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-03-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Pfizer-BioNTech | |
| 2 | 2021-01-28 | Pfizer-BioNTech | |
| 3 | 2021-09-04 | Pfizer-BioNTech | No |
| 4 | 2022-04-19 | Moderna | No |
| 5 | 2022-09-23 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-29 | Successful | Participant prefers to complete VAERS report online |
| 2021-07-29 | Successful 2021-08-06 |
Participant prefers to complete VAERS report online |
| 2023-03-24 | Unsuccessful |
Free text
Release 1 — day 7, dose 1
Systemic reaction (other): Itching & slight swelling on small portion of left palm
Release 2 — day 14, dose 1
Symptoms: Small itchy area on left palm. Mild.
Release 8 — 3 months, dose 2
Symptoms: Headaches last 3.5 weeks. Garbled hearing and hearing loss for 1 week. Both middle ears are filled with fluid. Taking Mucinex to drain sinuses for 2 days. Still have headaches and reduced hearing. It is like my head is an echo chamber.
Release 9 — 6 months, dose 2
Symptoms: Daily headaches. Episodes of lightheartedness that sometimes worsens into vertigo and vomiting. Hearing is sometimes decreased, sometimes garbled, ringing sometimes high pitched, sometimes my head seems to amplify low frequencies.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Ringing in ears
Systemic reaction (other): Ringing in ears
Systemic reaction (other): Ear ringing
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Periodic dizziness
Systemic reaction (other): Dizziness
Systemic reaction (other): Dizziness
Release 12 — day 7, dose 5
Systemic reaction (other): Dizzy
Release 12 — day 21, dose 5
Symptoms: Body aches, tiredness, sore throat, low grade fever, ear pain, jaw pain
Release 12 — day 42, dose 5
Symptoms: Deep cough
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 | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Deafness | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | · | ✓ |
| SD | Ear pain | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hypoacusis | ✓ | ✓ | ✓ |
| SD | Middle ear effusion | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in jaw | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Tinnitus | ✓ | · | ✓ |
| SD | Vertigo | ✓ | · | ✓ |
| SD | Vomiting | ✓ | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Tinnitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release