Y7X-28636-20721 · OpenVSafe

Timeline

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

2021-03-17
Dose 1 — Pfizer-BioNTech
2021-03-18
Registered in v-safe
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Anaphylactic reaction, Immediate post-injection reaction — Feeling: Poor · Site: Pain, Swelling · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Anaphylactic reaction five minutes after receiving injection. Having another anaphylactic reaction today that started at 2:30pm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Anaphylactic reaction, Central venous catheterisation, Endotracheal intubation, Gastrointestinal tube insertion, Hospitalisation, Intensive care, Mechanical ventilation, Throat tightness — Feeling: Poor · Site: Swelling · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): Again today Anaphylactic reaction throat closing up at 4:59am this morning and again at 9:27am. Currently intubated on a ventilator, PIC line, NG tube, catheter, epi drip · Healthcare visit (other): Currently in (b)(6) Medical PICU

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Hospitalisation, Hypersensitivity — Feeling: Poor · Site: Pain, Redness · Be unable to work, Be unable to do your normal daily activities

Free text: A deadly allergic reaction that still has me in the hospital

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Anaphylactic reaction, Hospitalisation, Immunisation reaction — Feeling: Poor · None · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Harley continues to be hospitalized due to multiple anaphylactic episodes from the vaccine. He was just taken off the ventilator and continues to be given steroids and antihistamines via IV

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-06
Call 1 — Left Voicemail
2021-10-06
Call successful
Reported to VAERS voluntarily prior to GDIT contact

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-03-18	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-03-19	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-03-22	Successful 2021-10-06	Reported to VAERS voluntarily prior to GDIT contact

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-18

Systemic reaction (other): Anaphylactic reaction five minutes after receiving injection. Having another anaphylactic reaction today that started at 2:30pm

2021-03-19

Systemic reaction (other): Again today Anaphylactic reaction throat closing up at 4:59am this morning and again at 9:27am. Currently intubated on a ventilator, PIC line, NG tube, catheter, epi drip

Healthcare visit (other): Currently in (b)(6) Medical PICU

redacted (b)(6)

Release 6 — days 1–6 daily, dose 1

2021-03-21

Systemic reaction (other): A deadly allergic reaction that still has me in the hospital

2021-03-22

Healthcare visit (other): Harley continues to be hospitalized due to multiple anaphylactic episodes from the vaccine. He was just taken off the ventilator and continues to be given steroids and antihistamines via IV

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	Anaphylactic reaction	✓	✓	✓
HCVO	Hospitalisation	✓	✓	✓
HCVO	Immunisation reaction	✓	✓	✓
HCVO	Intensive care	✓	✓	✓
SRO	Anaphylactic reaction	✓	✓	✓
SRO	Central venous catheterisation	✓	✓	✓
SRO	Endotracheal intubation	✓	✓	✓
SRO	Gastrointestinal tube insertion	✓	✓	✓
SRO	Hospitalisation	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Mechanical ventilation	✓	✓	✓
SRO	Throat tightness	✓	✓	✓

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