YXP-26984-32073

5 vaccinations 10 coded responses 48 check-ins 10 free-text entries 2 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 917 / CA
Registered: 2021-02-12

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

Timeline

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

2021-02-09
Dose 1 — Pfizer-BioNTech
2021-02-12
Registered in v-safe
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Somnolence — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Free text: Very sleepy 7 hours after the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus, Rash — Feeling: Good · Headache, Rash, not including the immediate area around the injection site

Free text: Rash and itchy at night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-16
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-23
Survey response — day 14, dose 1
MedDRA: Fatigue, Influenza like illness, Nasal congestion — Feeling: Good

Free text: Flu like,stuffy nose and fatigue in last three days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Dose 2 — Pfizer-BioNTech
2021-03-02
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness

Free text: A little dizzying

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Nasal congestion, Tremor — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Body shaking due to chills,stuffy nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Less severe symptoms than yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Immunisation reaction — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Better better today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-09
Health check-in — day 7, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-01
Survey response — 3 months, dose 2
MedDRA: Headache, Sinus disorder — Feeling: Fair · Be unable to do your normal daily activities, 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: I have been experiencing headache since 3 weeks after the second shot of vaccine ! It lasts til now. I hope this is not side effect of Covid 19 vacation because MRI shows I get sinus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
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)
2021-08-31
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Dose 3 — Pfizer-BioNTech
2021-09-29
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-09-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-10-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-10-06
Health check-in — day 7, dose 3
Feeling: Fair · Rash, not including the immediate area around the injection site

Adult check-in
2021-10-13
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-10-20
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-29
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-30
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-04-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-25
Dose 4 — Pfizer-BioNTech
2022-09-29
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in
2022-10-19
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-10-24
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2022-10-24
Survey response — 6 months, dose 4
MedDRA: Rash — Feeling: Fair

Free text: Rashes on arms & back

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Swelling · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2022-10-26
Survey response — day 7, dose 5
MedDRA: Rash, Self-medication — Feeling: Fair · Site: Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Applied cortisol medication on rash areas

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Report sent to call center — day 7, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-27
Call 1 — Left Voicemail
2022-10-27
Call successful
Participant prefers to complete VAERS report online
2022-11-02
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-09
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-16
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-23
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-30
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-18
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-19
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-09	Pfizer-BioNTech
2	2021-03-02	Pfizer-BioNTech
3	2021-09-29	Pfizer-BioNTech	No
4	2022-04-25	Pfizer-BioNTech	No
5	2022-10-19	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-06-01	Successful 2022-04-01	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-10-26	Successful 2022-10-27	Participant prefers to complete VAERS report online

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-13

Systemic reaction (other): Very sleepy 7 hours after the shot

2021-02-14

Systemic reaction (other): Rash and itchy at night

Release 4 — day 14, dose 1

2021-02-23

Symptoms: Flu like,stuffy nose and fatigue in last three days.

Release 4 — day 0, dose 2

2021-03-02

Systemic reaction (other): A little dizzying

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Body shaking due to chills,stuffy nose

2021-03-04

Systemic reaction (other): Less severe symptoms than yesterday

2021-03-05

Systemic reaction (other): Better better today

Release 8 — 3 months, dose 2

2021-06-01

Symptoms: I have been experiencing headache since 3 weeks after the second shot of vaccine ! It lasts til now. I hope this is not side effect of Covid 19 vacation because MRI shows I get sinus

Release 12 — 6 months, dose 4

2022-10-24

Symptoms: Rashes on arms & back

Release 12 — day 7, dose 5

2022-10-26

Healthcare visit (other): Applied cortisol medication on rash areas

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	Rash	·	·	✓
HCVO	Self-medication	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Influenza like illness	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Rash	·	·	✓
SD	Sinus disorder	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Immunisation reaction	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Tremor	✓	✓	✓

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