Y54-17174-52557

4 vaccinations 6 coded responses 30 check-ins 5 free-text entries 4 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 900 / CA
Registered: 2021-02-03

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
1628826 (opens in a new window)	high	9 / 11	—	4 of 7 VAERS symptoms	same dose (2)	CA matches	2021-02-14 / 2021-07-16 / 2021-08-24 received 272 days before the last call	case 940038

From the VAERS matching of call center cases (loader/vaers_match_*). Only the best match is shown, and only if it scores 8 or more out of 11. The score adds up timing (VAERS received soon after the call center contact), dose and shared symptoms; state only breaks ties. Confidence is high when the score is 8+ and at least 3 points ahead of the runner-up, medium when 5+ and 2 ahead, otherwise low. A match is a likely link, not a confirmed one.

Timeline

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

2021-01-24
Dose 1 — Pfizer-BioNTech
2021-02-03
Registered in v-safe
2021-02-03
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-14
Dose 2 — Pfizer-BioNTech
2021-02-14
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat. Mild.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-15
Survey response — 6 months, dose 2
MedDRA: Blood glucose decreased, Hypoglycaemia, Hypotension, Office visit, Weight decreased — 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

Free text: Symptoms: Low blood pressure. Low glucose. Hypoglycemic. Weight loss. · Healthcare visit (other): Appointment with my internist and cardiologist.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-15
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-22
Dose 3 — Pfizer-BioNTech
2021-08-23
Call 1 — Left Voicemail
2022-02-15
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-15
Dose 4 — Pfizer-BioNTech
2022-04-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-22
Survey response — day 7, dose 4
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-06
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-20
Survey response — day 35, dose 4
MedDRA: Cyst, Nodule, Pre-existing disease, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I have a cyst or nodule around the size of a quarter in my lower back left side that is very painful. I've had them in the past. They come and go. This one is extremely painful. · Healthcare visit (other): Trying to make a Doctors visit. Waiting for an appointment time.

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Report sent to call center — day 35, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-23
Call successful
Completed over the phone
2022-05-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-17
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-14
Survey response — 6 months, dose 4
MedDRA: Asthenia, Blood pressure decreased, Fatigue, Office visit, Orthostatic hypotension — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I get very tired and weak with light exercise or exertion, and my blood pressure drops substantially. It's called Orthostatic Hypotension. I have seen a cardiologist and my heart is ok. My Internist is doing tests to see what the cause is.

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-17
Survey response — 12 months, dose 4
MedDRA: Angioplasty, COVID-19, Coronary arterial stent insertion, SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

MedDRA releases: 2024-11
2023-04-17
Report sent to call center — 12 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2023-04-19
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-24	Pfizer-BioNTech
2	2021-02-14	Pfizer-BioNTech
3	2021-08-22	Pfizer-BioNTech	No
4	2022-04-15	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-15	Successful 2022-05-23	Completed over the phone
2022-05-20	Successful 2022-05-23	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-14	Successful 2022-10-18	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-17	Successful 2023-04-19	Does not wish to fill out VAERS report

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-17

Systemic reaction (other): Sore throat. Mild.

Release 9 — 6 months, dose 2

2021-08-15

Symptoms: Low blood pressure. Low glucose. Hypoglycemic. Weight loss.

Healthcare visit (other): Appointment with my internist and cardiologist.

Release 11 — day 7, dose 4

2022-04-22

Systemic reaction (other): No

Release 11 — day 35, dose 4

2022-05-20

Symptoms: I have a cyst or nodule around the size of a quarter in my lower back left side that is very painful. I've had them in the past. They come and go. This one is extremely painful.

Healthcare visit (other): Trying to make a Doctors visit. Waiting for an appointment time.

Release 12 — 6 months, dose 4

2022-10-14

Symptoms: I get very tired and weak with light exercise or exertion, and my blood pressure drops substantially. It's called Orthostatic Hypotension. I have seen a cardiologist and my heart is ok. My Internist is doing tests to see what the cause is.

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	Angioplasty	·	·	✓
HCVO	Coronary arterial stent insertion	·	·	✓
HCVO	COVID-19	·	·	✓
HCVO	Office visit	✓	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Angioplasty	·	·	✓
SD	Asthenia	·	·	✓
SD	Blood glucose decreased	✓	·	✓
SD	Blood pressure decreased	·	·	✓
SD	Coronary arterial stent insertion	·	·	✓
SD	COVID-19	·	·	✓
SD	Cyst	·	·	✓
SD	Fatigue	·	·	✓
SD	Hypoglycaemia	✓	·	✓
SD	Hypotension	✓	·	✓
SD	Nodule	·	·	✓
SD	Office visit	·	·	✓
SD	Orthostatic hypotension	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Weight decreased	✓	·	✓
SRO	No adverse event	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓

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