YY3-29151-86219

2 vaccinations 11 coded responses 20 check-ins 11 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 630 / MO
Registered: 2021-01-28

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Pfizer-BioNTech
2021-01-28
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: SARS-CoV-2 test — Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I tested for Covid19 Saturday 30th 2021

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches · Be unable to work

Free text: Cough started

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Fair · Site: Pain · Headache · Be unable to work, 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: Cough started steroids today 20mg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to work

Adult check-in
2021-02-04
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Headache · Be unable to work

Adult check-in
2021-02-11
Survey response — day 14, dose 1
MedDRA: Dyspnoea — Feeling: Poor · Be unable to work

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 21, dose 1
MedDRA: COVID-19, Oxygen consumption decreased, Oxygen saturation decreased, Pneumonia — Feeling: Fair · Be unable to work

Free text: I got Covid19 and have been working at (b)(6). I got phenomena and loss of my oxygen! I have been here a week. Im getting ready to go home. My oxygen has stayed up and my lungs are clearing out. So very good news.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-28
Dose 2 — Pfizer-BioNTech
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Cough

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: Dyspnoea — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work

Free text: Some shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-14
Survey response — day 14, dose 2
MedDRA: COVID-19, Medical counselling — Feeling: Poor · Be unable to work

Free text: Covid19 lung, saw lung Doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-28
Survey response — day 28, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Be unable to work

Free text: Shortness of breath,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-11
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-30
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Office visit — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Shortness of breath · Healthcare visit (other): MD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-03
Call 1 — Left Voicemail
2021-11-06
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Pfizer-BioNTech
2	2021-02-28	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-01-31	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-02-02	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-30	Successful 2021-11-06	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-31

Systemic reaction (other): I tested for Covid19 Saturday 30th 2021

2021-02-01

Systemic reaction (other): Cough started

2021-02-02

Systemic reaction (other): Cough started steroids today 20mg

Release 4 — day 14, dose 1

2021-02-11

Symptoms: Shortness of breath

Release 4 — day 21, dose 1

2021-02-18

Symptoms: I got Covid19 and have been working at (b)(6). I got phenomena and loss of my oxygen! I have been here a week. Im getting ready to go home. My oxygen has stayed up and my lungs are clearing out. So very good news.

redacted (b)(6)

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Cough

2021-03-05

Systemic reaction (other): Some shortness of breath

2021-03-06

Systemic reaction (other): Shortness of breath

Release 5 — day 14, dose 2

2021-03-14

Symptoms: Covid19 lung, saw lung Doctor

Release 6 — day 28, dose 2

2021-03-28

Symptoms: Shortness of breath,

Release 8 — 3 months, dose 2

2021-05-30

Symptoms: Shortness of breath

Healthcare visit (other): MD

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	Office visit	✓	✓	✓
SD	COVID-19	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Medical counselling	✓	✓	✓
SD	Oxygen consumption decreased	✓	✓	○
SD	Oxygen saturation decreased	·	·	✓
SD	Pneumonia	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	SARS-CoV-2 test	✓	✓	✓

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