YSM-13466-98487

2 vaccinations 4 coded responses 16 check-ins 4 free-text entries 1 call case

Sex: Male
Age at first dose: 61-65
ZIP prefix: 272 / NC
Registered: 2021-04-01

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

2021-03-28
Dose 1 — Pfizer-BioNTech
2021-04-01
Registered in v-safe
2021-04-01
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Asthenia, Dizziness, Fall, Feeling abnormal, Headache, Heart rate increased, Loss of consciousness, Pain — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I have some of those but when I click on the ability to type something here I dont check them all. I didnt know about this I got the vaccine couple of days ago and I felt horrible. I still have joint pain dizziness. The day of the shot I fell down so my child my dad did it. I just basically passed out with a rapid heartbeat and a lot of pain and weakness. But when I got the shot nobody told me the information was on the piece of paper to login and Ive been trying to find a login and password to get here since I got the vaccine. They couldve done that a lot better. Sunday when I got the shot, I got home I had a headache very dizzy, I fell, hard,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

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

Adult check-in
2021-04-11
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-25
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-27
Dose 2 — Pfizer-BioNTech
2021-05-09
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-27
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Fatigue, Headache, Nasal congestion — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: TiredJoint pointStuffyHeadache

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

1 call case(s)
2021-08-05
Call 1 — Left Voicemail
2021-08-05
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-10-26
Survey response — 6 months, dose 2
MedDRA: Amnesia, Balance disorder, Fatigue, Somnolence — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Extreme fatigue. Need to sleep for half an hour every two hours. Memory lost. Loss of balance I don't know why I feel this out. CDC did call me after I told you how bad the vaccine affected me. They directed me to go use the website I can already us

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Survey response — 12 months, dose 2
MedDRA: Adverse reaction, Malaise — Feeling: Poor · Be unable to work or attend school

Free text: Why do I bother writing it. I had a bad reaction to the vaccine and I'm not touching the boosters because I was so sick. The CDC even called me and then they referred me to the website that you can put unfiltered data in his feedback. CDC is useless.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-28	Pfizer-BioNTech
2	2021-04-27	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-07-27	Successful 2021-08-05	Reported to VAERS voluntarily prior to GDIT contact

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-01

Systemic reaction (other): I have some of those but when I click on the ability to type something here I dont check them all. I didnt know about this I got the vaccine couple of days ago and I felt horrible. I still have joint pain dizziness. The day of the shot I fell down so my child my dad did it. I just basically passed out with a rapid heartbeat and a lot of pain and weakness. But when I got the shot nobody told me the information was on the piece of paper to login and Ive been trying to find a login and password to get here since I got the vaccine. They couldve done that a lot better. Sunday when I got the shot, I got home I had a headache very dizzy, I fell, hard,

Release 9 — 3 months, dose 2

2021-07-27

Symptoms: TiredJoint pointStuffyHeadache

Release 10 — 6 months, dose 2

2021-10-26

Symptoms: Extreme fatigue. Need to sleep for half an hour every two hours. Memory lost. Loss of balance I don't know why I feel this out. CDC did call me after I told you how bad the vaccine affected me. They directed me to go use the website I can already us cut off by CDC

Release 11 — 12 months, dose 2

2022-04-27

Symptoms: Why do I bother writing it. I had a bad reaction to the vaccine and I'm not touching the boosters because I was so sick. The CDC even called me and then they referred me to the website that you can put unfiltered data in his feedback. CDC is useless. cut off by CDC

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	Adverse reaction	·	·	✓
SD	Amnesia	·	·	✓
SD	Arthralgia	✓	·	✓
SD	Balance disorder	·	·	✓
SD	Fatigue	✓	·	✓
SD	Headache	✓	·	✓
SD	Malaise	·	·	✓
SD	Nasal congestion	✓	·	✓
SD	Somnolence	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fall	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Loss of consciousness	✓	✓	✓
SRO	Pain	✓	✓	✓

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