YVS-16541-81576

2 vaccinations 14 coded responses 24 check-ins 14 free-text entries 4 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 441 / OH
Registered: 2021-03-11

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-11
Registered in v-safe
2021-03-11
Dose 1 — Pfizer-BioNTech
2021-03-11
Survey response — day 0, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Headache

Free text: Recent neurosurgery

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Glossodynia, Tongue blistering — Feeling: Good · Site: Pain, Itching · Muscle or body aches

Free text: Big Blood blister on my toung ..last night still sore but down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Blood blister, Glossodynia, Pain, Sleep disorder — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Blood blister on my toung night after injection resolved BUT PAIN HAS INCREASED UNDER TOUNG WHERE IT INTERFERS WITH MY SLEEPING..and eating causes pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Glossodynia — Feeling: Good · Fatigue or tiredness

Free text: Still have sore tounge

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

Free text: Sore tounge

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Cold sweat, Hyperhidrosis, Nausea — Feeling: Poor · Fever · Headache, Nausea

Free text: Clamy sweaty nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-01
Dose 2 — Pfizer-BioNTech
2021-04-01
Health check-in — day 0, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Taste disorder — Feeling: Good · Site: Pain, Itching · Muscle or body aches

Free text: Change in taste since after the 2nd 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: Good · None

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Headache — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Extreem fatigue and constant headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Headache, Abdominal pain

Adult check-in
2021-04-15
Survey response — day 14, dose 2
MedDRA: Chest discomfort, Rash, Tongue blistering — Feeling: Fair

Free text: Small bumps and rash.also a hollow feeling in my chest. Blood blisters continue to appear on or under my toung

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-29
Survey response — day 28, dose 2
MedDRA: Chest discomfort, Fatigue, Medical counselling — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Heavy feeling in center of chest and increasing fatigue · Healthcare visit (other): Call to doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-13
Survey response — day 42, dose 2
MedDRA: Cardiac disorder, Medical counselling — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Heart condition · Healthcare visit (other): Reffered to a cardiologist by primary

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-01
Survey response — 3 months, dose 2
MedDRA: Cardiomegaly, Nausea, Rash, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Bumps..rashes. Enlarged heart..constant nausea · Healthcare visit (other): Multiple test including cardiologist nuclear stress test 6/ 30/ 2021

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-08
Call 1 — Could Not Reach Participant
2021-07-13
Call 2 — Could Not Reach Participant
2021-09-30
Survey response — 6 months, dose 2
MedDRA: Chest pain, Neuralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nerve pain/ chest pain

MedDRA releases: 2024-11 · check-in free text available
2022-04-03
Survey response — 12 months, dose 2
MedDRA: Asthenia, Chest pain, Fatigue — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Chest pains weakness and fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-04-03
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 · 1 call case(s)
2022-04-04
Call 1 — Could Not Reach Participant
2022-04-07
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Pfizer-BioNTech
2	2021-04-01	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-04-29	Unsuccessful
2021-05-13	Unsuccessful
2021-07-01	Unsuccessful
2022-04-03	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-11

Systemic reaction (other): Recent neurosurgery

Release 5 — days 1–6 daily, dose 1

2021-03-12

Systemic reaction (other): Big Blood blister on my toung ..last night still sore but down

2021-03-13

Systemic reaction (other): Blood blister on my toung night after injection resolved BUT PAIN HAS INCREASED UNDER TOUNG WHERE IT INTERFERS WITH MY SLEEPING..and eating causes pain

2021-03-14

Systemic reaction (other): Still have sore tounge

2021-03-16

Systemic reaction (other): Sore tounge

2021-03-17

Systemic reaction (other): Clamy sweaty nausea

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): Change in taste since after the 2nd shot

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Extreem fatigue and constant headache

Release 7 — day 14, dose 2

2021-04-15

Symptoms: Small bumps and rash.also a hollow feeling in my chest. Blood blisters continue to appear on or under my toung

Release 8 — day 28, dose 2

2021-04-29

Symptoms: Heavy feeling in center of chest and increasing fatigue

Healthcare visit (other): Call to doctor

Release 8 — day 42, dose 2

2021-05-13

Symptoms: Heart condition

Healthcare visit (other): Reffered to a cardiologist by primary

Release 9 — 3 months, dose 2

2021-07-01

Symptoms: Bumps..rashes. Enlarged heart..constant nausea

Healthcare visit (other): Multiple test including cardiologist nuclear stress test 6/ 30/ 2021

Release 9 — 6 months, dose 2

2021-09-30

Symptoms: Nerve pain/ chest pain

Release 11 — 12 months, dose 2

2022-04-03

Symptoms: Chest pains weakness and fatigue

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	Medical counselling	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Asthenia	·	·	✓
SD	Cardiac disorder	✓	✓	✓
SD	Cardiomegaly	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Neuralgia	·	·	✓
SD	Rash	✓	✓	✓
SD	Tongue blistering	✓	✓	✓
SRO	Blood blister	✓	✓	✓
SRO	Cold sweat	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Glossodynia	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓
SRO	Taste disorder	✓	✓	✓
SRO	Tongue blistering	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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