Y5A-23744-84918
5 vaccinations
7 coded responses
49 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 156 / PA
- Registered
- 2021-03-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-12
Registered in v-safe
-
2021-03-12
Dose 1 — Pfizer-BioNTech
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-26
-
2021-04-02
Dose 2 — Pfizer-BioNTech
- 2021-04-02
- 2021-04-04
- 2021-04-05
-
2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-07
- 2021-04-08
-
2021-04-09
Survey response — day 7, dose 2MedDRA: Lethargy — Feeling: Good · Fatigue or tirednessFree text: Lethargy. Better description than tiredness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-07-02
- 2021-10-01
-
2021-11-08
Dose 3 — Pfizer-BioNTech
- 2022-04-02
- 2022-05-09
-
2022-07-18
Dose 4 — Pfizer-BioNTech
- 2022-07-18
- 2022-07-19
- 2022-07-20
- 2022-07-21
- 2022-07-22
- 2022-07-23
- 2022-07-24
- 2022-07-25
- 2022-08-01
- 2022-08-08
- 2022-08-24
- 2022-08-29
- 2022-10-17
-
2022-10-18
Dose 5 — Pfizer-BioNTech
-
2022-10-18
Survey response — day 0, dose 5MedDRA: Visual impairment — Feeling: Good · Fatigue or tirednessFree text: Black spots in left eye vision a few times within 3 hours of injection. Not "floaters" - more like small black discs timesMedDRA releases: 2024-11 · check-in free text available
-
2022-10-19
Health check-in — days 1–6 daily, dose 5Feeling: Good · Chills, Fatigue or tirednessAdult check-in
- 2022-10-20
- 2022-10-21
-
2022-10-23
Survey response — days 1–6 daily, dose 5MedDRA: Visual impairment, Vitreous floaters — Feeling: Good · FeverFree text: Black floating spots in left eye vision. Bigger but much fewer than the ones experienced in hours after vaccine administration. They move like "floaters.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-24
Survey response — days 1–6 daily, dose 5MedDRA: Dry eye — Feeling: Good · Fatigue or tirednessFree text: Dry left eye ?.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-25
- 2022-11-03
-
2022-11-08
Survey response — day 21, dose 5MedDRA: Vitreous floaters — Feeling: GoodFree text: Big floater in left eye. See my comments before on this condition.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-17
Survey response — day 28, dose 5MedDRA: Nasopharyngitis, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Cold like symptoms. Thought perhaps it might be sinus infection.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-17
Report sent to call center — day 28, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-18
-
2023-01-17
Survey response — 3 months, dose 5MedDRA: COVID-19, Influenza, Malaise — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Pfizer-BioNTech | |
| 2 | 2021-04-02 | Pfizer-BioNTech | |
| 3 | 2021-11-08 | Pfizer-BioNTech | No |
| 4 | 2022-07-18 | Pfizer-BioNTech | No |
| 5 | 2022-10-18 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-17 | Unsuccessful |
Free text
Release 7 — day 7, dose 2
Systemic reaction (other): Lethargy. Better description than tiredness.
Release 12 — day 0, dose 5
Systemic reaction (other): Black spots in left eye vision a few times within 3 hours of injection. Not "floaters" - more like small black discs times
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Black floating spots in left eye vision. Bigger but much fewer than the ones experienced in hours after vaccine administration. They move like "floaters.
Systemic reaction (other): Dry left eye ?.
Release 12 — day 21, dose 5
Symptoms: Big floater in left eye. See my comments before on this condition.
Release 12 — day 28, dose 5
Symptoms: Cold like symptoms. Thought perhaps it might be sinus infection.
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 | COVID-19 | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Vitreous floaters | · | · | ✓ |
| SRO | Dry eye | · | · | ✓ |
| SRO | Lethargy | ✓ | ✓ | ✓ |
| SRO | Visual impairment | · | · | ✓ |
| SRO | Vitreous floaters | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release