YM6-17100-79939

2 vaccinations 12 coded responses 22 check-ins 12 free-text entries 1 call case

Sex: Male
Age at first dose: 36-40
ZIP prefix: 995 / AK
Registered: 2021-03-12

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

2021-03-12
Registered in v-safe
2021-03-12
Dose 1 — Pfizer-BioNTech
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Angina pectoris, Immediate post-injection reaction — Feeling: Good · Site: Pain, Swelling

Free text: About 5 minutes after the injection I had what I can only describe as two "tinges" of a weird pain in or above my heart. About the size of a quarter. 2 tinges right after each other and that was it. Cant say it was related but you never know.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good

Free text: A weird little lightly painful blotch on the bottom of my foot. But don't know if it's related to the shot,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Rash, Rash erythematous — Feeling: Good · Joint pains, Rash, not including the immediate area around the injection site

Free text: I have a Tony red rash looking mark on the inside of my bicep on the same arm as the injection. It also looks like the little rash/blister on the bottom of my right foot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Joint pains, Rash, not including the immediate area around the injection site

Free text: Same as before but improved

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 7, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Pfizer-BioNTech
2021-04-02
Survey response — day 0, dose 2
MedDRA: Arthralgia, Immediate post-injection reaction, Musculoskeletal pain, Pain, Pain in extremity — Feeling: Good · Joint pains

Free text: Had some weird small pain "waves" travel from bottom of shoulder blade to middle knuckleOn my left arm about 5 minutes after the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Chest discomfort, Limb discomfort, Muscle spasms — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Muscle spasms/non painful "flutters" in pecks and left bicep. Also a weird sore ok right wrist,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle discomfort — Feeling: Good · Site: Pain

Free text: Muscle flutters in right upper pectoral

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Night sweats — Feeling: Good · Chills

Free text: I forgot to mention the second day after the shot I had major night sweats.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Skin ulcer — Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Still have the red marks although very slight on left inner bicep that showed up after the first shot. Also still have the round sore on right wrist.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Survey response — day 14, dose 2
MedDRA: Cervicogenic headache, Tenderness — Feeling: Good

Free text: Headache , cervicogenic, but weird nerve like tenderness ok a couple on my head. Like base of skull on back of neck right side and temple, right side.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 42, dose 2
MedDRA: Arthralgia, Neuralgia — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: More random joint pain and nerve pain. May not be related... But not sure.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-04
Survey response — 12 months, dose 2
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Got omicron

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
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	2021-03-12	Pfizer-BioNTech
2	2021-04-02	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-05-14	Successful 2022-05-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): About 5 minutes after the injection I had what I can only describe as two "tinges" of a weird pain in or above my heart. About the size of a quarter. 2 tinges right after each other and that was it. Cant say it was related but you never know.

2021-03-15

Systemic reaction (other): A weird little lightly painful blotch on the bottom of my foot. But don't know if it's related to the shot,

2021-03-17

Systemic reaction (other): I have a Tony red rash looking mark on the inside of my bicep on the same arm as the injection. It also looks like the little rash/blister on the bottom of my right foot

2021-03-18

Systemic reaction (other): Same as before but improved

Release 6 — day 0, dose 2

2021-04-02

Systemic reaction (other): Had some weird small pain "waves" travel from bottom of shoulder blade to middle knuckleOn my left arm about 5 minutes after the shot

Release 6 — days 1–6 daily, dose 2

2021-04-04

Systemic reaction (other): Muscle spasms/non painful "flutters" in pecks and left bicep. Also a weird sore ok right wrist,

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Muscle flutters in right upper pectoral

2021-04-07

Systemic reaction (other): I forgot to mention the second day after the shot I had major night sweats.

2021-04-08

Systemic reaction (other): Still have the red marks although very slight on left inner bicep that showed up after the first shot. Also still have the round sore on right wrist.

Release 7 — day 14, dose 2

2021-04-16

Symptoms: Headache , cervicogenic, but weird nerve like tenderness ok a couple on my head. Like base of skull on back of neck right side and temple, right side.

Release 8 — day 42, dose 2

2021-05-14

Symptoms: More random joint pain and nerve pain. May not be related... But not sure.

Release 11 — 12 months, dose 2

2022-04-04

Symptoms: Got omicron

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	Cervicogenic headache	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Neuralgia	✓	✓	✓
SD	Tenderness	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Angina pectoris	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Muscle discomfort	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Musculoskeletal pain	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Skin ulcer	✓	✓	✓

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