Y3Y-14279-98126

3 vaccinations 8 coded responses 9 check-ins 8 free-text entries 5 call cases

Sex: Male
Age at first dose: 41-45
ZIP prefix: 229 / VA
Registered: 2022-01-04

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

2021-02-08
Dose 1 — Pfizer-BioNTech
2021-03-01
Dose 2 — Pfizer-BioNTech
2021-12-28
Dose 3 — Pfizer-BioNTech
2022-01-04
Registered in v-safe
2022-01-04
Survey response — day 7, dose 3
MedDRA: Brain oedema — Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school

Free text: Head felt swollen; concerned about cerebral venous thrombosis now that I'm 7 days out from booster

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Survey response — day 14, dose 3
MedDRA: Rash, Rash vesicular — Feeling: Fair

Free text: Rash with blisters on ankles and wrists

MedDRA releases: 2024-11 · check-in free text available
2022-01-18
Survey response — day 21, dose 3
MedDRA: Chest discomfort — Feeling: Fair

Free text: Chest tightness at night lying down

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Survey response — day 28, dose 3
MedDRA: Eczema, Pemphigoid, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Worsening eczema or bullous pemphigoid

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-03
Survey response — day 35, dose 3
MedDRA: Anxiety, Head discomfort, Headache, Paraesthesia, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Head pressure/ache and anxiety 2 nights at bedtime with tingling of arms/legs/face · Healthcare visit (other): Scheduled for Monday

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-07
Call 2 — Left Voicemail
2022-02-08
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-29
Survey response — 3 months, dose 3
MedDRA: Anaphylactic reaction, Dyspnoea, Eczema, Exercise tolerance decreased, Injection site pain, Paraesthesia, Peripheral swelling, Urticaria — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Hives, Anaphylaxis, Eczema, Dyspnea, Exercise Intolerance, lower limb tingling, hepatic vein enlargement, injection site pain, swollen knuckles, delayed pressure hives, etc.

MedDRA releases: 2024-11 · check-in free text available
2022-03-29
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-03-31
Call 2 — Left Voicemail
2022-06-28
Survey response — 6 months, dose 3
MedDRA: Biliary obstruction, Cholelithiasis, Orthopnoea, Urticaria pressure — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Gallstones or biliary duct obstruction, delayed pressure urticaria, orthopnea

MedDRA releases: 2024-11 · check-in free text available
2022-06-28
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-29
Call 1 — Left Voicemail
2022-06-29
Call 3 — Left Voicemail
2022-06-29
Call 3 — Left Voicemail
2022-06-29
Call 2 — Left Voicemail
2022-12-31
Survey response — 12 months, dose 3
MedDRA: Fatigue, Headache, Thrombophlebitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Upper arm thrombophlebitis Spurious lightning headaches Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-12-31
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2023-01-03
Call 1 — Left Voicemail
2023-01-03
Call 1 — Left Voicemail
2023-01-03
Call 1 — Left Voicemail
2023-01-03
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Pfizer-BioNTech	No
2	2021-03-01	Pfizer-BioNTech	No
3	2021-12-28	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-25	Successful 2022-01-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-03	Unsuccessful
2022-03-29	Unsuccessful
2022-06-28	Unsuccessful
2022-12-31	Unsuccessful

Free text

Release 10 — day 7, dose 3

2022-01-04

Systemic reaction (other): Head felt swollen; concerned about cerebral venous thrombosis now that I'm 7 days out from booster

Release 10 — day 14, dose 3

2022-01-11

Symptoms: Rash with blisters on ankles and wrists

Release 10 — day 21, dose 3

2022-01-18

Symptoms: Chest tightness at night lying down

Release 11 — day 28, dose 3

2022-01-25

Symptoms: Worsening eczema or bullous pemphigoid

Release 11 — day 35, dose 3

2022-02-03

Symptoms: Head pressure/ache and anxiety 2 nights at bedtime with tingling of arms/legs/face

Healthcare visit (other): Scheduled for Monday

Release 11 — 3 months, dose 3

2022-03-29

Symptoms: Hives, Anaphylaxis, Eczema, Dyspnea, Exercise Intolerance, lower limb tingling, hepatic vein enlargement, injection site pain, swollen knuckles, delayed pressure hives, etc.

Release 12 — 6 months, dose 3

2022-06-28

Symptoms: Gallstones or biliary duct obstruction, delayed pressure urticaria, orthopnea

Release 12 — 12 months, dose 3

2022-12-31

Symptoms: Upper arm thrombophlebitis Spurious lightning headaches Fatigue

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	Unevaluable event	·	·	✓
SD	Anaphylactic reaction	·	·	✓
SD	Anxiety	·	·	✓
SD	Biliary obstruction	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Cholelithiasis	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Eczema	·	·	✓
SD	Exercise tolerance decreased	·	·	✓
SD	Fatigue	·	·	✓
SD	Head discomfort	·	·	✓
SD	Headache	·	·	✓
SD	Injection site pain	·	·	✓
SD	Orthopnoea	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Pemphigoid	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	·	·	✓
SD	Rash vesicular	·	·	✓
SD	Thrombophlebitis	·	·	✓
SD	Urticaria	·	·	✓
SD	Urticaria pressure	·	·	✓
SRO	Brain oedema	·	·	✓

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