YK7-19503-77142

2 vaccinations 8 coded responses 24 check-ins 8 free-text entries 3 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 940 / CA
Registered: 2021-04-09

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

2021-04-09
Registered in v-safe
2021-04-09
Dose 1 — Pfizer-BioNTech
2021-04-09
Survey response — day 0, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Site: Pain

Free text: Type 2 Diabetes, Hypertension, Diabetic Polyneuropathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Itching · Chills, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-16
Health check-in — day 7, dose 1
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-23
Survey response — day 14, dose 1
MedDRA: Fatigue, Lethargy, Somnolence — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Tired, sleepy, and lethargic.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-07
Dose 2 — Pfizer-BioNTech
2021-05-07
Survey response — day 0, dose 2
MedDRA: Diabetes mellitus, Diabetic neuropathy, Hypertension, Pre-existing disease — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Type 2 Diabetes, Hypertension, Diabetic Polyneuropathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-05-10
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-05-12
Report sent to call center — days 1–6 daily, 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)
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-14
Survey response — day 7, dose 2
MedDRA: Back pain — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Back ache previous to 2nd vaccine injection l

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — day 14, dose 2
MedDRA: Chills, Injection site warmth, Pain — Feeling: Fair

Free text: Body aches plus chill in middle of last 21night Thursday 5/20/20 to Friday 5/21/21Went to outdoor event with other vaccinated individuals then in a meeting room in a circle.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-14
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-09
Survey response — 3 months, dose 2
MedDRA: Aphonia, Diarrhoea, Headache, Nasal congestion, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headache, Sneezing, stuffy nose, loss of voice when attempting to speak, diarrhea

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-05
Survey response — 6 months, dose 2
MedDRA: Cough, Decreased appetite, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Coughing, tired, loss of appetite

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Call 1 — Left Voicemail
2022-05-10
Survey response — 12 months, dose 2
MedDRA: Arthralgia, Back pain — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Back ache and left knee pain

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-11
Call 1 — Left Voicemail
2022-05-11
Call 2 — Left Voicemail
2022-05-11
Call 1 — Left Voicemail
2022-05-12
Callback requested for
01:30 CT
2022-05-12
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-09	Pfizer-BioNTech
2	2021-05-07	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-05-10	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-05-12	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-10	Successful 2022-05-12	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — day 0, dose 1

2021-04-09

Systemic reaction (other): Type 2 Diabetes, Hypertension, Diabetic Polyneuropathy

Release 7 — day 14, dose 1

2021-04-23

Symptoms: Tired, sleepy, and lethargic.

Release 8 — day 0, dose 2

2021-05-07

Systemic reaction (other): Type 2 Diabetes, Hypertension, Diabetic Polyneuropathy

Release 8 — day 7, dose 2

2021-05-14

Systemic reaction (other): Back ache previous to 2nd vaccine injection l

Release 8 — day 14, dose 2

2021-05-21

Symptoms: Body aches plus chill in middle of last 21night Thursday 5/20/20 to Friday 5/21/21Went to outdoor event with other vaccinated individuals then in a meeting room in a circle.

Release 9 — 3 months, dose 2

2021-08-09

Symptoms: Headache, Sneezing, stuffy nose, loss of voice when attempting to speak, diarrhea

Release 10 — 6 months, dose 2

2021-11-05

Symptoms: Coughing, tired, loss of appetite

Release 11 — 12 months, dose 2

2022-05-10

Symptoms: Back ache and left knee 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	Aphonia	✓	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Chills	✓	✓	✓
SD	Cough	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	·	✓
SD	Injection site warmth	✓	✓	○
SD	Lethargy	✓	✓	✓
SD	Nasal congestion	✓	·	✓
SD	Pain	✓	✓	✓
SD	Sneezing	✓	·	✓
SD	Somnolence	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Diabetes mellitus	○	✓	○
SRO	Diabetic neuropathy	○	✓	○
SRO	Hypertension	○	✓	○
SRO	Pre-existing disease	✓	✓	✓

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