Z3J-37346-86678

4 vaccinations 9 coded responses 30 check-ins 9 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 201 / VA
Registered: 2021-03-04

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-04
Registered in v-safe
2021-03-04
Dose 1 — Pfizer-BioNTech
2021-03-04
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair

Free text: Slight light headedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Hyperhidrosis — Feeling: Good

Free text: Sweating tho not profusely

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Anorectal discomfort, Frequent bowel movements — Feeling: Fair

Free text: Frequent bowl movements (staying two days after the vaccine) leading to rectal discomfort; not diarrhea but often.

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

Adult check-in
2021-03-18
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-25
Dose 2 — Pfizer-BioNTech
2021-03-25
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain, Feeling abnormal — Feeling: Fair

Free text: Foggy head; ear ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperhidrosis — Feeling: Fair · Fatigue or tiredness

Free text: Sweating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — day 7, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Fatigue or tiredness

Free text: Foggy-headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-29
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-06
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-24
Dose 3 — Pfizer-BioNTech
2021-09-25
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-02
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-10-05
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2021-11-25
Survey response — 3 months, dose 3
MedDRA: Cardiac failure, Hospitalisation, Pneumonia, Pulmonary thrombosis — Feeling: Fair · 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, Hospitalization

Free text: I had pneumonia lung blood clots and associated heart failure. Hospitalization was 12 days.

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Hospitalization · 1 call case(s)
2021-12-21
Dose 4 — Pfizer-BioNTech
2022-01-13
Call successful
Participant prefers to complete VAERS report online
2022-02-22
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-06-21
Survey response — 6 months, dose 4
MedDRA: Acute kidney injury — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Acute renal failure

MedDRA releases: 2024-11 · check-in free text available
2022-06-21
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2022-06-22
Call 1 — Left Voicemail
2022-06-22
Call 1 — Left Voicemail
2022-12-22
Survey response — 12 months, dose 4
MedDRA: Nodule, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Nodules in the right armpit requiring antibiotics and a surgery consultation(pending) · Healthcare visit (other): Visit with PCP and surgeon

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-12-23
Call 2 — Left Voicemail
2022-12-23
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Pfizer-BioNTech
2	2021-03-25	Pfizer-BioNTech
3	2021-08-24	Pfizer-BioNTech	No
4	2021-12-21	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-25	Successful 2022-01-13	Participant prefers to complete VAERS report online
2022-06-21	Unsuccessful
2022-12-22	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-04

Systemic reaction (other): Slight light headedness

Release 5 — days 1–6 daily, dose 1

2021-03-07

Systemic reaction (other): Sweating tho not profusely

2021-03-10

Systemic reaction (other): Frequent bowl movements (staying two days after the vaccine) leading to rectal discomfort; not diarrhea but often.

Release 6 — days 1–6 daily, dose 2

2021-03-29

Systemic reaction (other): Foggy head; ear ache

2021-03-31

Systemic reaction (other): Sweating

Release 6 — day 7, dose 2

2021-04-01

Systemic reaction (other): Foggy-headed

Release 10 — 3 months, dose 3

2021-11-25

Symptoms: I had pneumonia lung blood clots and associated heart failure. Hospitalization was 12 days.

Release 12 — 6 months, dose 4

2022-06-21

Symptoms: Acute renal failure

Release 12 — 12 months, dose 4

2022-12-22

Symptoms: Nodules in the right armpit requiring antibiotics and a surgery consultation(pending)

Healthcare visit (other): Visit with PCP and surgeon

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	Acute kidney injury	·	·	✓
SD	Cardiac failure	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Nodule	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pulmonary thrombosis	·	·	✓
SRO	Anorectal discomfort	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Frequent bowel movements	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓

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