Z24-26798-60072

2 vaccinations 9 coded responses 20 check-ins 9 free-text entries 1 call case

Sex: Male
Age at first dose: 56-60
ZIP prefix: 331 / FL
Registered: 2021-03-24

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-21
Dose 1 — Janssen/Johnson & Johnson
2021-03-24
Registered in v-safe
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — day 7, dose 1
Feeling: Good · None

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

Adult check-in
2021-04-11
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-04-18
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-04-25
Survey response — day 35, single dose
MedDRA: Abdominal discomfort, Diarrhoea, Injection site pain, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: April 25, 2021: woke up feverish with some pain on the site of the vaccine injection upper left arm (no visible inflammation tho). Stomach upset and light diarrhea in the morning before eating or taking meds (only drank water throughout the night).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — day 42, single dose
Feeling: Fair

Adult check-in
2021-06-20
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-09-20
Survey response — 6 months, dose 1
MedDRA: Anxiety, Fatigue, Office visit, Pain, Pre-existing disease, Vertigo — Feeling: Poor · Be unable to work or attend school, 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, Emergency room or emergency department visit

Free text: Symptoms: Severe pain attacks, vertigo, anxiety, fatigue from preexisting brain tumor, nerve damage and autoimmune disease -not from vaccine · Healthcare visit (other): Specialists

MedDRA releases: 2024-11 · check-in free text available
2021-09-20
Report sent to call center — 6 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-22
Call 1 — Left Voicemail
2021-10-23
Dose 2 — Pfizer-BioNTech
2021-11-03
Survey response — day 7, dose 2
MedDRA: Brain neoplasm, Pain — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Pain from brain tumor

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Survey response — day 14, dose 2
MedDRA: Pain, Pre-existing disease — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Severe pain attacks from brain tumor/chronic paraxysmal hemicrania/nerve damage pain plus vertigo, lichen sclerosus/varicoceles, anxiety and depression NOT FROM VACCINES

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — day 21, dose 2
MedDRA: Brain neoplasm, Dermatitis, Diarrhoea, Headache, Nausea, Trigeminal neuralgia, Vertigo — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: From brain tumor: headache attacks, trigeminal nerve pain, vertigo, nausea, diarrhea, skin inflamation THESE SYMPTOMS ARE NOT FROM THE VACCINE

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — day 28, dose 2
MedDRA: Pre-existing disease — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: *Symptoms from Brain Tumor: chronic paroxysmal hemicrania, trigeminal nerve damage, cluster headache attacks, vertigo attacks, lichen sclerosus flares, nausea, chronic acid reflux, constant coughing *THESE SYMPTOMS ARE NOT FROM THE COVID VACCINE

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Survey response — day 35, dose 2
MedDRA: Brain neoplasm, Chronic paroxysmal hemicrania, Cough, Diarrhoea, Fatigue, Nausea, Panic attack, Trigeminal nerve disorder, Vertigo — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Symptoms from Brain Tumor: pain attacks, chronic paroxysmal hemicrania, trigeminal nerve damage, vertigo attacks, diarreah, coughing, nausea, extreme fatigue NO SYMPTOMS FROM THE VACCINE

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Survey response — day 42, dose 2
MedDRA: Anxiety, Brain neoplasm, Facial pain, Fatigue, Headache, Nausea, Rash, Vertigo — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Symptons from brain tumor NOT FROM VACCINE: head and face pain attacks, anxiety attacks with vertigo and nausea, fatigue, skin rashes

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Health check-in — 3 months, dose 2
Feeling: Poor

Adult check-in
2022-04-24
Survey response — 6 months, dose 2
MedDRA: Brain neoplasm, Cough, Diarrhoea, Headache, Oropharyngeal pain, Pain, Skin irritation, Vertigo — Feeling: Poor · Be unable to work or attend school

Free text: Head pain attacks, vertigo, body pain from brain tumor, skin irritation, cough, sore throat, diarrhea

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-21	Janssen/Johnson & Johnson
2	2021-10-23	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-20	Unsuccessful

Free text

Release 7 — day 35, single dose

2021-04-25

Symptoms: April 25, 2021: woke up feverish with some pain on the site of the vaccine injection upper left arm (no visible inflammation tho). Stomach upset and light diarrhea in the morning before eating or taking meds (only drank water throughout the night). cut off by CDC

Release 9 — 6 months, dose 1

2021-09-20

Symptoms: Severe pain attacks, vertigo, anxiety, fatigue from preexisting brain tumor, nerve damage and autoimmune disease -not from vaccine

Healthcare visit (other): Specialists

Release 10 — day 7, dose 2

2021-11-03

Systemic reaction (other): Pain from brain tumor

Release 10 — day 14, dose 2

2021-11-08

Symptoms: Severe pain attacks from brain tumor/chronic paraxysmal hemicrania/nerve damage pain plus vertigo, lichen sclerosus/varicoceles, anxiety and depression NOT FROM VACCINES

Release 10 — day 21, dose 2

2021-11-15

Symptoms: From brain tumor: headache attacks, trigeminal nerve pain, vertigo, nausea, diarrhea, skin inflamation THESE SYMPTOMS ARE NOT FROM THE VACCINE

Release 10 — day 28, dose 2

2021-11-22

Symptoms: *Symptoms from Brain Tumor: chronic paroxysmal hemicrania, trigeminal nerve damage, cluster headache attacks, vertigo attacks, lichen sclerosus flares, nausea, chronic acid reflux, constant coughing *THESE SYMPTOMS ARE NOT FROM THE COVID VACCINE

Release 10 — day 35, dose 2

2021-11-29

Symptoms: Symptoms from Brain Tumor: pain attacks, chronic paroxysmal hemicrania, trigeminal nerve damage, vertigo attacks, diarreah, coughing, nausea, extreme fatigue NO SYMPTOMS FROM THE VACCINE

Release 10 — day 42, dose 2

2021-12-06

Symptoms: Symptons from brain tumor NOT FROM VACCINE: head and face pain attacks, anxiety attacks with vertigo and nausea, fatigue, skin rashes

Release 11 — 6 months, dose 2

2022-04-24

Symptoms: Head pain attacks, vertigo, body pain from brain tumor, skin irritation, cough, sore throat, diarrhea

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	Abdominal discomfort	✓	✓	✓
SD	Anxiety	·	·	✓
SD	Brain neoplasm	·	·	✓
SD	Chronic paroxysmal hemicrania	·	·	✓
SD	Cough	·	·	✓
SD	Dermatitis	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Facial pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Panic attack	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	·	·	✓
SD	Skin irritation	·	·	✓
SD	Trigeminal nerve disorder	·	·	✓
SD	Trigeminal neuralgia	·	·	✓
SD	Vertigo	·	·	✓
SRO	Brain neoplasm	·	·	✓
SRO	Pain	·	·	✓

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