YGW-25051-39710

4 vaccinations 14 coded responses 35 check-ins 13 free-text entries 1 call case

Sex: Male
Age at first dose: 61-65
ZIP prefix: 282 / NC
Registered: 2021-04-13

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

2021-03-23
Dose 1 — Pfizer-BioNTech
2021-04-13
Registered in v-safe
2021-04-13
Dose 2 — Pfizer-BioNTech
2021-04-13
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, COVID-19, Depression, Dyspnoea, Fatigue, Feeling abnormal, Office visit, Respiratory tract congestion — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Im still having shortness of breath, a lot of congestion that my dr has tried several remedies that havent worked, brain fog, fatigue, & depression after having covid in November 2020.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety, Depression, Somnolence — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Depression & anxiety bad today. Slept most if the day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Hypersomnia — Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Slept most of the day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 7, dose 2
MedDRA: Hypersomnia — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Slept most of the day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-25
Survey response — day 42, dose 2
MedDRA: Arthralgia, Back pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Extreme knee & back pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-10
Dose 3 — Pfizer-BioNTech
2021-10-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-15
Survey response — days 1–6 daily, dose 3
MedDRA: Depression — Feeling: Good · Be unable to do your normal daily activities

Free text: Depression

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Survey response — days 1–6 daily, dose 3
MedDRA: Depression — Feeling: Good

Free text: Depression

MedDRA releases: 2024-11 · check-in free text available
2021-10-17
Survey response — day 7, dose 3
MedDRA: Depression — Feeling: Fair

Free text: Depression

MedDRA releases: 2024-11 · check-in free text available
2021-10-24
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-31
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-07
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-14
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-01
Dose 4 — Pfizer-BioNTech
2022-04-10
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-18
Survey response — day 14, dose 4
MedDRA: Herpes zoster — Feeling: Fair · Be unable to do your normal daily activities

Free text: Shingles

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Survey response — day 21, dose 4
MedDRA: Herpes zoster — Feeling: Good · Be unable to do your normal daily activities

Free text: Shingles

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-06
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-13
Survey response — day 42, dose 4
MedDRA: Constipation, Pollakiuria — Feeling: Fair · Be unable to do your normal daily activities

Free text: Constipation, frequent urinating

MedDRA releases: 2024-11 · check-in free text available
2022-07-02
Survey response — 3 months, dose 4
MedDRA: Diabetes mellitus, Glycosylated haemoglobin increased, Office visit, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: A1C jumped from 6 to 13 on May 25th. 14 years being a diabetic & no meds were needed until now. · Healthcare visit (other): Saw my PCP & Endocrinologist

MedDRA releases: 2024-11 · check-in free text available
2022-07-02
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-05
Call successful
Not applicable - Accidental Reporting
2022-09-30
Survey response — 6 months, dose 4
MedDRA: Anaemia, Renal impairment — Feeling: Fair · Be unable to do your normal daily activities

Free text: Anemia, kidneys levels not high enough, possible cancer diagnosis

MedDRA releases: 2024-11 · check-in free text available
2023-04-01
Survey response — 12 months, dose 4
MedDRA: Bladder catheterisation, Bladder obstruction, Pre-existing disease — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-23	Pfizer-BioNTech
2	2021-04-13	Pfizer-BioNTech
3	2021-10-10	Pfizer-BioNTech	No
4	2022-04-01	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-07-02	Successful 2022-07-05	Not applicable - Accidental Reporting

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Im still having shortness of breath, a lot of congestion that my dr has tried several remedies that havent worked, brain fog, fatigue, & depression after having covid in November 2020.

2021-04-17

Systemic reaction (other): Depression & anxiety bad today. Slept most if the day.

2021-04-19

Systemic reaction (other): Slept most of the day

Release 7 — day 7, dose 2

2021-04-21

Systemic reaction (other): Slept most of the day

Release 8 — day 42, dose 2

2021-05-25

Symptoms: Extreme knee & back pain.

Release 10 — days 1–6 daily, dose 3

2021-10-15

Systemic reaction (other): Depression

2021-10-16

Systemic reaction (other): Depression

Release 10 — day 7, dose 3

2021-10-17

Systemic reaction (other): Depression

Release 11 — day 14, dose 4

2022-04-18

Symptoms: Shingles

Release 11 — day 21, dose 4

2022-04-22

Symptoms: Shingles

Release 11 — day 42, dose 4

2022-05-13

Symptoms: Constipation, frequent urinating

Release 12 — 3 months, dose 4

2022-07-02

Symptoms: A1C jumped from 6 to 13 on May 25th. 14 years being a diabetic & no meds were needed until now.

Healthcare visit (other): Saw my PCP & Endocrinologist

Release 12 — 6 months, dose 4

2022-09-30

Symptoms: Anemia, kidneys levels not high enough, possible cancer diagnosis

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	Anaemia	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Bladder catheterisation	·	·	✓
SD	Bladder obstruction	·	·	✓
SD	Constipation	·	·	✓
SD	Diabetes mellitus	·	·	✓
SD	Glycosylated haemoglobin increased	·	·	✓
SD	Herpes zoster	·	·	✓
SD	Pollakiuria	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Renal impairment	·	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Brain fog	·	·	✓
SRO	COVID-19	·	·	✓
SRO	Depression	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	○
SRO	Hypersomnia	✓	✓	✓
SRO	Office visit	·	·	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Somnolence	✓	✓	✓

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