Y6G-13019-65879
4 vaccinations
9 coded responses
41 check-ins
8 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 468 / IN
- Registered
- 2021-02-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-05
Registered in v-safe
-
2021-02-05
Dose 1 — Pfizer-BioNTech
- 2021-02-05
- 2021-02-06
-
2021-02-07
Survey response — days 1–6 daily, dose 1MedDRA: Respiratory tract congestion — Feeling: Fair · Fever · Fatigue or tirednessFree text: Head convrpestion - but I doubt that its related. I get those anyways.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-08
-
2021-02-09
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
- 2021-02-10
- 2021-02-11
-
2021-02-12
Survey response — day 7, dose 1MedDRA: Back pain, Dyspnoea, Hypopnoea, Medical counselling, Muscle strain, Office visit, Self-medication — Feeling: Good · Muscle or body achesFree text: (While this isnt a muscle ache, there was no other way to submit my message). Thursday evening, starting around 7, I developed a pain in my lower right back. It progressively got worst over the nex t4 hours - to the point where it became difficult to take deep breaths. Had to take shallow ones. Almost called EMS. It since Ive been through something similar before, I treated it the same - with I ibuprofen. After an hour it settled down. I do not think it is related to the vaccine. I consulted with my Primary Care Physician, and he thinks its a muscle strain. (I dont.) I had a visit to my allergist last Wednesday morning and he listened to my lungs. Said they were clear. So I dont think this issue relates at all.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
-
2021-02-26
Dose 2 — Pfizer-BioNTech
- 2021-02-26
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tirednessFree text: Shoulder ache at injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-01
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Joint painsFree text: Left shoulder, site of 1st injection. Wierd. I refuse to correlate, though.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-19
-
2021-03-26
Survey response — day 28, dose 2MedDRA: Bronchitis — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Bronchitis. Started over a week ago.I cant necessarily associate it with the vaccine though - as I am prone to getting bronchitis in the early spring.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-02
-
2021-04-09
Survey response — day 42, dose 2MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Am tired all the time. (But I dont think its related.)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-28
-
2021-08-27
Survey response — 6 months, dose 2MedDRA: Ageusia, SARS-CoV-2 test — Feeling: GoodFree text: Taste buds seem muted. (No other symptoms, but I decided to have a COVID test done today, just in case.)MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-08
Dose 3 — Pfizer-BioNTechCo-administered: yes
- 2022-02-26
-
2022-04-22
Dose 4 — Pfizer-BioNTech
- 2022-04-22
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-04-27
- 2022-04-28
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-07-22
-
2022-10-21
Survey response — 6 months, dose 4MedDRA: Bronchitis — Feeling: FairFree text: Bronchitis. Not related to booster.MedDRA releases: 2024-11 · check-in free text available
-
2023-04-24
Survey response — 12 months, dose 4MedDRA: COVID-19, Embolism, Pulmonary embolism — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
-
2023-04-24
Report sent to call center — 12 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2023-04-25
-
2023-04-25
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Pfizer-BioNTech | |
| 2 | 2021-02-26 | Pfizer-BioNTech | |
| 3 | 2021-10-08 | Pfizer-BioNTech | Yes |
| 4 | 2022-04-22 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-04-24 | Successful 2023-04-25 |
Not applicable - Accidental Reporting |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Head convrpestion - but I doubt that its related. I get those anyways.
Release 4 — day 7, dose 1
Systemic reaction (other): (While this isnt a muscle ache, there was no other way to submit my message). Thursday evening, starting around 7, I developed a pain in my lower right back. It progressively got worst over the nex t4 hours - to the point where it became difficult to take deep breaths. Had to take shallow ones. Almost called EMS. It since Ive been through something similar before, I treated it the same - with I ibuprofen. After an hour it settled down. I do not think it is related to the vaccine. I consulted with my Primary Care Physician, and he thinks its a muscle strain. (I dont.) I had a visit to my allergist last Wednesday morning and he listened to my lungs. Said they were clear. So I dont think this issue relates at all.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Shoulder ache at injection site.
Systemic reaction (other): Left shoulder, site of 1st injection. Wierd. I refuse to correlate, though.
Release 6 — day 28, dose 2
Symptoms: Bronchitis. Started over a week ago.I cant necessarily associate it with the vaccine though - as I am prone to getting bronchitis in the early spring.
Release 7 — day 42, dose 2
Symptoms: Am tired all the time. (But I dont think its related.)
Release 9 — 6 months, dose 2
Symptoms: Taste buds seem muted. (No other symptoms, but I decided to have a COVID test done today, just in case.)
Release 12 — 6 months, dose 4
Symptoms: Bronchitis. Not related to booster.
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 | Embolism | · | · | ✓ |
| SD | Ageusia | ✓ | · | ✓ |
| SD | Bronchitis | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Pulmonary embolism | · | · | ✓ |
| SD | SARS-CoV-2 test | ✓ | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Hypopnoea | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Medical counselling | ✓ | ✓ | ✓ |
| SRO | Muscle strain | ✓ | ✓ | ✓ |
| SRO | Office visit | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release