Y5K-60111-26250

4 vaccinations 5 coded responses 36 check-ins 5 free-text entries 1 call case

Sex: Male
Age at first dose: 61-65
ZIP prefix: 662 / KS
Registered: 2021-03-28

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

2021-03-27
Dose 1 — Pfizer-BioNTech
2021-03-28
Registered in v-safe
2021-03-28
Survey response — days 1–6 daily, dose 1
MedDRA: Antibiotic therapy, Condition aggravated, Pre-existing disease — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Currently on antibiotic protocol (clindamycin) for oral root canal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-17
Dose 2 — Pfizer-BioNTech
2021-04-17
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 7, dose 2
Feeling: Good · None

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

Adult check-in
2021-05-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-26
Survey response — day 35, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities

Free text: Seasonal allergies are hitting me much harder than in the past. I dont know if this is me, specific to difference in allergen components or has some relation to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2022-04-17
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-03
Dose 4 — Pfizer-BioNTech
2022-05-03
Survey response — day 0, dose 4
MedDRA: Feeling abnormal, Injection site pain — Feeling: Fair

Free text: A little spacey, fuzzy-headed. Earlier vaccinations did not cause any noticeable side-effects other than a little pain at the injection site.

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-05-11
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-17
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-31
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-06-14
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-08-02
Survey response — 3 months, dose 4
MedDRA: COVID-19 — Feeling: Poor · Be unable to work or attend school

Free text: Covid

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Survey response — 6 months, dose 4
MedDRA: Arthralgia, Office visit, Pain — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Acute pain in knee · Healthcare visit (other): Private doctor visit

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-02
Call successful
Participant prefers to complete VAERS report online
2023-05-03
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Pfizer-BioNTech
2	2021-04-17	Pfizer-BioNTech
3	2021-11-05	Pfizer-BioNTech	Flu
4	2022-05-03	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-11-01	Successful 2022-11-02	Participant prefers to complete VAERS report online

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-28

Systemic reaction (other): Currently on antibiotic protocol (clindamycin) for oral root canal

Release 8 — day 35, dose 2

2021-05-26

Symptoms: Seasonal allergies are hitting me much harder than in the past. I dont know if this is me, specific to difference in allergen components or has some relation to the vaccine.

Release 11 — day 0, dose 4

2022-05-03

Systemic reaction (other): A little spacey, fuzzy-headed. Earlier vaccinations did not cause any noticeable side-effects other than a little pain at the injection site.

Release 12 — 3 months, dose 4

2022-08-02

Symptoms: Covid

Release 12 — 6 months, dose 4

2022-11-01

Symptoms: Acute pain in knee

Healthcare visit (other): Private doctor visit

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	Office visit	·	·	✓
SD	Arthralgia	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Antibiotic therapy	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Feeling abnormal	·	·	✓
SRO	Injection site pain	·	·	✓
SRO	Pre-existing disease	✓	✓	✓

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