Y8Z-17428-31882

2 vaccinations 13 coded responses 25 check-ins 13 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 653 / MO
Registered: 2021-01-15

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

2021-01-15
Registered in v-safe
2021-01-15
Dose 1 — Pfizer-BioNTech
2021-01-15
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-16
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: About the same as couple weeks after getting over COVID

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — day 7, dose 1
MedDRA: Asthenia — Feeling: Good · Fatigue or tiredness

Free text: Feeling very good. Now to get my strength back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Survey response — day 21, dose 1
MedDRA: Arthritis, Pre-existing disease — Feeling: Good · Be unable to work

Free text: My arthritis has flared up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-19
Dose 2 — Moderna
2021-02-19
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperaesthesia, Pain of skin — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Skin is painful like every nerve is firing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Diarrhoea — Feeling: Good · Site: Pain · Joint pains, Diarrhea

Free text: Have loose stool not diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Dyspnoea — Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Nausea

Free text: Tright chess slight breathing difficulty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Dyspnoea — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Breathing tright chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Dyspnoea — Feeling: Good · Joint pains, Fatigue or tiredness

Free text: Breathing and tightness of chest is better today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory disorder — Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Free text: Breathing is improving

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — day 7, dose 2
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Free text: Breathing is getting better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 35, dose 2
MedDRA: COVID-19, Dyspnoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: My breathing has not returned to prior COVID

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-20
Survey response — 6 months, dose 2
MedDRA: Dizziness, Dyspnoea, Fatigue, Headache, Productive cough, Sneezing, Unevaluable event — Feeling: Poor · Be unable to work or attend school, 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: Been sick the last 14 days None productive cough, sinus, sneezing, head ach, tired, light headed, breathing difficulty had to use my emergency Methylprednisolone Dosepak

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-20
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-24
Call 1 — Left Voicemail
2022-02-19
Survey response — 12 months, dose 2
MedDRA: Arthralgia, Emergency care — Feeling: Good · Be unable to do your normal daily activities

Free text: ED, still having join pain

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Pfizer-BioNTech
2	2021-02-19	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-16	priority 2/3
2021-08-20	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-19

Systemic reaction (other): About the same as couple weeks after getting over COVID

Release 2 — day 7, dose 1

2021-01-22

Systemic reaction (other): Feeling very good. Now to get my strength back

Release 3 — day 21, dose 1

2021-02-05

Symptoms: My arthritis has flared up

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): Skin is painful like every nerve is firing

2021-02-21

Systemic reaction (other): Have loose stool not diarrhea

2021-02-22

Systemic reaction (other): Tright chess slight breathing difficulty

2021-02-23

Systemic reaction (other): Breathing tright chest

2021-02-24

Systemic reaction (other): Breathing and tightness of chest is better today

2021-02-25

Systemic reaction (other): Breathing is improving

Release 4 — day 7, dose 2

2021-02-26

Systemic reaction (other): Breathing is getting better

Release 6 — day 35, dose 2

2021-03-26

Symptoms: My breathing has not returned to prior COVID

Release 9 — 6 months, dose 2

2021-08-20

Symptoms: Been sick the last 14 days None productive cough, sinus, sneezing, head ach, tired, light headed, breathing difficulty had to use my emergency Methylprednisolone Dosepak

Release 11 — 12 months, dose 2

2022-02-19

Symptoms: ED, still having join pain

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	Arthralgia	·	·	✓
SD	Arthritis	✓	✓	✓
SD	COVID-19	✓	✓	✓
SD	Dizziness	✓	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Emergency care	·	·	✓
SD	Fatigue	✓	·	✓
SD	Headache	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Productive cough	✓	·	✓
SD	Sneezing	✓	·	✓
SD	Unevaluable event	✓	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Hyperaesthesia	✓	✓	✓
SRO	Pain of skin	✓	✓	✓
SRO	Respiratory disorder	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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