YC4-31763-24451

2 vaccinations 10 coded responses 22 check-ins 10 free-text entries 3 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 376 / TN
Registered: 2021-03-26

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

2021-03-25
Dose 1 — Pfizer-BioNTech
2021-03-26
Registered in v-safe
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Survey response — days 1–6 daily, dose 1
MedDRA: Oral herpes — Feeling: Good

Free text: Severe fever blister

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — days 1–6 daily, dose 1
MedDRA: Oral herpes — Feeling: Good

Free text: Bad cold sore on lip

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — days 1–6 daily, dose 1
MedDRA: Oral herpes — Feeling: Good

Free text: Major cold sore on lip

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 1
MedDRA: Oral herpes — Feeling: Good

Free text: Cold sore on lip starting to dry up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-15
Dose 2 — Pfizer-BioNTech
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Good

Free text: Just a little soreness in the arm that was vaccinated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
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 · Fatigue or tiredness

Adult check-in
2021-04-22
Survey response — day 7, dose 2
MedDRA: Adverse reaction — Feeling: Good

Free text: I get a flu shot every year, 60 years old, i have had very little problems with either shot but a lot of people i know that dont regularly get a flu shot seem to be the people with the wost symptoms from the vaccines, just sayin.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 14, dose 2
MedDRA: Hospitalisation, Pancreatitis — Feeling: Poor · 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: Symptoms: Pancreatitis, realiy bad · Healthcare visit (other): Have been in hospital for 6 da/s

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — day 14, dose 2
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)
2021-05-06
Survey response — day 21, dose 2
MedDRA: Pancreatitis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Been in hospital with pancreatitis since April 25

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — day 28, dose 2
MedDRA: Pain, Pancreatitis acute — Feeling: Fair · 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: Still in a lot of pain from having acute pancreatitis, but a little better than before. Have had no problems from vaccines.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — day 28, dose 2
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)
2021-05-20
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-27
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-16
Survey response — 3 months, dose 2
MedDRA: Abdominal wall cyst, Office visit — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Had acute necrotic pancreatitis that hit me about 2-3 weeks after i had 2nd vaccine. Wondered if there was any reason that may have happened. After a period of time the necrotic tissue has created a cyst about 4 inches long beneath right rib cage. · Healthcare visit (other): Dr visit, with procedures Monday the 17th of july.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-16
Report sent to call center — 3 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)
2021-07-23
Call successful
Participant prefers to complete VAERS report online
2021-10-15
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-15
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-25	Pfizer-BioNTech
2	2021-04-15	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-04-29	Successful
2021-05-13	Successful
2021-07-16	Successful 2021-07-23	Participant prefers to complete VAERS report online

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-28

Systemic reaction (other): Severe fever blister

2021-03-29

Systemic reaction (other): Bad cold sore on lip

2021-03-30

Systemic reaction (other): Major cold sore on lip

2021-03-31

Systemic reaction (other): Cold sore on lip starting to dry up

Release 7 — days 1–6 daily, dose 2

2021-04-16

Systemic reaction (other): Just a little soreness in the arm that was vaccinated

Release 7 — day 7, dose 2

2021-04-22

Systemic reaction (other): I get a flu shot every year, 60 years old, i have had very little problems with either shot but a lot of people i know that dont regularly get a flu shot seem to be the people with the wost symptoms from the vaccines, just sayin.

Release 8 — day 14, dose 2

2021-04-29

Symptoms: Pancreatitis, realiy bad

Healthcare visit (other): Have been in hospital for 6 da/s

Release 8 — day 21, dose 2

2021-05-06

Symptoms: Been in hospital with pancreatitis since April 25

Release 8 — day 28, dose 2

2021-05-13

Symptoms: Still in a lot of pain from having acute pancreatitis, but a little better than before. Have had no problems from vaccines.

Release 9 — 3 months, dose 2

2021-07-16

Symptoms: Had acute necrotic pancreatitis that hit me about 2-3 weeks after i had 2nd vaccine. Wondered if there was any reason that may have happened. After a period of time the necrotic tissue has created a cyst about 4 inches long beneath right rib cage.

Healthcare visit (other): Dr visit, with procedures Monday the 17th of july.

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	Hospitalisation	✓	✓	✓
HCVO	Office visit	✓	·	✓
SD	Abdominal wall cyst	✓	·	✓
SD	Office visit	✓	·	✓
SD	Pain	✓	✓	✓
SD	Pancreatitis	✓	✓	✓
SD	Pancreatitis acute	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Oral herpes	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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