Z6Z-28874-05190

2 vaccinations 5 coded responses 17 check-ins 5 free-text entries 3 call cases

Sex: Male
Age at first dose: 51-55
ZIP prefix: 953 / CA
Registered: 2021-04-03

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

2021-04-03
Registered in v-safe
2021-04-03
Dose 1 — Pfizer-BioNTech
2021-04-03
Health check-in — day 0, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-24
Dose 2 — Pfizer-BioNTech
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-01
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
2021-05-08
Survey response — day 14, dose 2
MedDRA: Unevaluable event — Feeling: Fair · 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: It looks like Im getting shingles.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Report sent to call center — day 14, 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)
2021-05-15
Survey response — day 21, dose 2
MedDRA: Fatigue, Herpes zoster — Feeling: Fair · 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: I had a breakout of shingles and my fatigue still is an issue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Report sent to call center — day 21, 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)
2021-05-22
Survey response — day 28, dose 2
MedDRA: Fatigue, Herpes zoster — Feeling: Fair · Be unable to do your normal daily activities

Free text: Still have sings of shingles and fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-07-24
Survey response — 3 months, dose 2
MedDRA: Brain fog, Disturbance in attention, Dry eye, Herpes zoster — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I have broken out in shingles twice! I have problems with dry eyes and I am experience times of cloudy thoughts or problems focusing. I have never had any of they symptoms before getting the vaccine.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-25
Survey response — 6 months, dose 2
MedDRA: Anxiety, Depression, Frustration tolerance decreased — Feeling: Poor · 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: Depression, anxiety frustrations that I've told you all this on the stupid thing and you've never done anything about it.

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-26
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-03	Pfizer-BioNTech
2	2021-04-24	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-05-08	Successful	Participant prefers to complete VAERS report online
2021-05-15	Successful	Participant prefers to complete VAERS report online
2021-10-25	Successful 2021-10-26	Participant prefers to complete VAERS report online

Free text

Release 8 — day 14, dose 2

2021-05-08

Symptoms: It looks like Im getting shingles.

Release 8 — day 21, dose 2

2021-05-15

Symptoms: I had a breakout of shingles and my fatigue still is an issue

Release 8 — day 28, dose 2

2021-05-22

Symptoms: Still have sings of shingles and fatigue.

Release 9 — 3 months, dose 2

2021-07-24

Symptoms: I have broken out in shingles twice! I have problems with dry eyes and I am experience times of cloudy thoughts or problems focusing. I have never had any of they symptoms before getting the vaccine.

Release 10 — 6 months, dose 2

2021-10-25

Symptoms: Depression, anxiety frustrations that I've told you all this on the stupid thing and you've never done anything about it.

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
SD	Anxiety	·	·	✓
SD	Brain fog	✓	·	✓
SD	Depression	·	·	✓
SD	Disturbance in attention	✓	·	✓
SD	Dry eye	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Frustration tolerance decreased	·	·	✓
SD	Herpes zoster	✓	✓	✓
SD	Unevaluable event	✓	✓	✓

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