YNQ-21539-70199

4 vaccinations 5 coded responses 41 check-ins 5 free-text entries 2 call cases

Sex: Male
Age at first dose: 46-50
ZIP prefix: 547 / WI
Registered: 2021-04-05

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

2021-04-05
Registered in v-safe
2021-04-05
Dose 1 — Pfizer-BioNTech
2021-04-05
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-26
Dose 2 — Pfizer-BioNTech
2021-04-26
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Itching · Headache

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction, Pre-existing disease — Feeling: Poor · Chills, Headache, Nausea, Vomiting, Diarrhea

Free text: I do not think my symptoms today had anything to do with the vaccine. I have pre-existing conditions where these symptoms have occurred many times before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Headache, Nausea, Vomiting

Free text: Probably not related to vaccine i have preexisting conditions.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-17
Survey response — day 21, dose 2
MedDRA: Pre-existing disease — Feeling: Good

Free text: I believe it's unrelated to the vaccine, i have experienced an increase in problems with my throat, it started after a neck surgery and has been getting worse over the last month. I have been more active which is why its worse, in my opinion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-27
Survey response — 3 months, dose 2
MedDRA: Animal scratch, Eye infection, Superficial injury of eye — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Infected scratched eye from my dogs nail.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-27
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-04
Call 1 — Left Voicemail
2021-10-26
Health check-in — 6 months, dose 2
Feeling: Poor

Adult check-in
2022-04-06
Dose 3 — Pfizer-BioNTech
2022-04-26
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-04-26
Survey response — 12 months, dose 2
MedDRA: Neck surgery, Shoulder operation, Spinal operation, Surgery — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Surgery on shoulder, radio-frequency ablasions to my neck and back. Oh, i did receive a booster shot of the Pfizer vaccine. · Healthcare visit (other): Outpatient ambulatory surgery

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-27
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-04-27
Call 1 — Left Voicemail
2022-05-04
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-05-11
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-05-18
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-07-06
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-09-20
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-09-20
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache

Adult check-in
2022-09-21
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-23
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-09-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-09-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-09-27
Health check-in — day 7, dose 4
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-10-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-11
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-18
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-21
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-21
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-05	Pfizer-BioNTech
2	2021-04-26	Pfizer-BioNTech
3	2022-04-06	Pfizer-BioNTech	No
4	2022-09-20	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-07-27	Unsuccessful
2022-04-26	Unsuccessful

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-01

Systemic reaction (other): I do not think my symptoms today had anything to do with the vaccine. I have pre-existing conditions where these symptoms have occurred many times before.

2021-05-02

Systemic reaction (other): Probably not related to vaccine i have preexisting conditions.

Release 8 — day 21, dose 2

2021-05-17

Symptoms: I believe it's unrelated to the vaccine, i have experienced an increase in problems with my throat, it started after a neck surgery and has been getting worse over the last month. I have been more active which is why its worse, in my opinion.

Release 9 — 3 months, dose 2

2021-07-27

Symptoms: Infected scratched eye from my dogs nail.

Release 11 — 12 months, dose 2

2022-04-26

Symptoms: Surgery on shoulder, radio-frequency ablasions to my neck and back. Oh, i did receive a booster shot of the Pfizer vaccine.

Healthcare visit (other): Outpatient ambulatory surgery

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	Surgery	·	·	✓
SD	Animal scratch	✓	·	✓
SD	Eye infection	✓	·	✓
SD	Neck surgery	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Shoulder operation	·	·	✓
SD	Spinal operation	·	·	✓
SD	Superficial injury of eye	✓	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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