Z6H-16657-77001
2 vaccinations
5 coded responses
18 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 26-30
- ZIP prefix
- 334 / FL
- Registered
- 2021-02-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-27
Registered in v-safe
-
2021-02-27
Dose 1 — Pfizer-BioNTech
- 2021-02-27
- 2021-02-28
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-06
-
2021-03-13
Survey response — day 14, dose 1MedDRA: Diabetes mellitus, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesFree text: I'm not sure if there was any relation, but about 3-4 days ago, my glucose levels were some of the highest I've ever had, including the length of how high my numbers were (I am a Type 1 Diabetic, since diagnosis at age 11).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-20
Dose 2 — Pfizer-BioNTech
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2021-03-22
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Tremor — Feeling: Fair · Site: PainFree text: On the day of the shot, March 20th, I felt fine. The next morning, I had very sudden and extreme chills to the point of not being able to stop shaking. Then shortly after, a mild fever (100)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
- 2021-03-29
- 2021-04-03
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2021-04-10
Survey response — day 21, dose 2MedDRA: Contusion, Injection site pain — Feeling: GoodFree text: I had slight, intermittent pain where I received the injection for a day or so, but it went away after 24 hours. My arm is still slightly bruised, which is surprising to me as the first shot did not cause brushing at all.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-17
Survey response — day 28, dose 2MedDRA: Blood glucose increased, Diabetes mellitus, Insulin resistance, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: About a week after my 2nd shot, I had some of the highest glucose levels (I'm a type 1 Diabetic), for the longest time I've ever experienced. More importantly, the high levels continued, and became a regular thing. I'm highly insulin resistant now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-24
Survey response — day 35, dose 2MedDRA: Insulin resistance, Unevaluable event — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: The insulin resistance issue continues, yet it has party resided. The problem is, it is now not 100 percent of the time, so half of the time I am going low, and the other half very high. Please look into this immediately, and publish it on CDC.gov · Healthcare visit (other): I am spekamg with my endo about it now, and will have an appointment soon.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-24
Report sent to call center — day 35, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-01
- 2021-06-19
- 2021-09-22
- 2022-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-27 | Pfizer-BioNTech | |
| 2 | 2021-03-20 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-24 | Unsuccessful |
Free text
Release 5 — day 14, dose 1
Symptoms: I'm not sure if there was any relation, but about 3-4 days ago, my glucose levels were some of the highest I've ever had, including the length of how high my numbers were (I am a Type 1 Diabetic, since diagnosis at age 11).
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): On the day of the shot, March 20th, I felt fine. The next morning, I had very sudden and extreme chills to the point of not being able to stop shaking. Then shortly after, a mild fever (100)
Release 7 — day 21, dose 2
Symptoms: I had slight, intermittent pain where I received the injection for a day or so, but it went away after 24 hours. My arm is still slightly bruised, which is surprising to me as the first shot did not cause brushing at all.
Release 7 — day 28, dose 2
Symptoms: About a week after my 2nd shot, I had some of the highest glucose levels (I'm a type 1 Diabetic), for the longest time I've ever experienced. More importantly, the high levels continued, and became a regular thing. I'm highly insulin resistant now. cut off by CDC
Release 7 — day 35, dose 2
Symptoms: The insulin resistance issue continues, yet it has party resided. The problem is, it is now not 100 percent of the time, so half of the time I am going low, and the other half very high. Please look into this immediately, and publish it on CDC.gov
Healthcare visit (other): I am spekamg with my endo about it now, and will have an appointment soon.
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Blood glucose increased | ✓ | ✓ | ✓ |
| SD | Contusion | ✓ | ✓ | ✓ |
| SD | Diabetes mellitus | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Insulin resistance | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release