Z7H-29787-56675

3 vaccinations 12 coded responses 38 check-ins 12 free-text entries 3 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 481 / MI
Registered: 2021-02-20

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

2021-02-20
Registered in v-safe
2021-02-20
Dose 1 — Pfizer-BioNTech
2021-02-20
Survey response — day 0, dose 1
MedDRA: Arthralgia, Condition aggravated, Pre-existing disease — Feeling: Good

Free text: Mild pre-existing shoulder ache on non-vaccinated side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-25
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Muscle or body aches

Free text: Note this symptom can reasonably be ascribed to toting two sets of twos of 53 and 14 months about as a daycare grandparent

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-13
Dose 2 — Pfizer-BioNTech
2021-03-13
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: If I press on the site I can feel a dull pain that its there; otherwise I dont notice. I keep replying Im fine. But I did have 8 CABG in 2011 that went very well to this day, and I did have an A1c in January of 11.7. Nonetheless I really do feel pretty good at 78.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Blah to the point of napping.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: A dermatology exam Tuesday then a CT ANGIO scan with contrast on Wednesday and our grand childrens (4) Gastro flu last week

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-21
Survey response — day 7, dose 2
MedDRA: Blood glucose increased, Diabetic ketoacidosis, Hospitalisation, Vomiting — Feeling: Poor · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Turns out I have severe dÃabetic keto acidosis; threw up went to ER and got admitted; sugar level reached 695, then 395, 269, 148, 153, 180, as they turrare to a good level with two IVs and a catheter. Clearly another problem than COVID-19 for which I test negative

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-03
Health check-in — day 21, dose 2
Feeling: Poor

Adult check-in
2021-04-10
Survey response — day 28, dose 2
MedDRA: Hospitalisation, Pyrexia — Feeling: Poor

Free text: Fever and am in hospital

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-12
Survey response — 3 months, dose 2
MedDRA: Bladder catheterisation, Diabetic ketoacidosis, Hospitalisation — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: I had a Supra pubic catheter installed and continued my recovery from hospitalizations for DKA Mar 20-23 and Apr 4-15.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-12
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-11
Survey response — 6 months, dose 2
MedDRA: Hospitalisation, Urinary tract infection, Urine analysis abnormal — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: I got a UTI treated in hospital with IV antibiotics, as result of a urological teat

MedDRA releases: 2024-11 · check-in free text available
2021-09-11
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

1 call case(s)
2021-09-13
Call 1 — Left Voicemail
2021-09-30
Call 2 — Could Not Reach Participant
2021-10-02
Dose 3 — Pfizer-BioNTech
2021-10-02
Survey response — day 0, dose 3
MedDRA: Unevaluable event — Feeling: Good

Free text: The shot was only 45 minutes ago

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-09
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-01
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-03
Survey response — 6 months, dose 3
MedDRA: Nasopharyngitis, Office visit — Feeling: Fair

Free text: I have a cold caught from doing daycare for two-year-old twins and maybe their five-year-old twin siblings. My wife (who actually had COVID two months ago, mildly while I did not) and I are both recovering well. Cardiologist says I'm fine etc

MedDRA releases: 2024-11 · check-in free text available
2022-10-02
Survey response — 12 months, dose 3
MedDRA: Nasopharyngitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: A nasty traditional cold brought to us by grandchildren twins for whom we do daycare three times weekly or more

MedDRA releases: 2024-11 · check-in free text available
2022-10-02
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-03
Call 3 — Left Voicemail
2022-10-03
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-20	Pfizer-BioNTech
2	2021-03-13	Pfizer-BioNTech
3	2021-10-02	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-12	Successful 2021-06-22	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-11	Unsuccessful
2022-10-02	Unsuccessful

Free text

Release 4 — day 0, dose 1

2021-02-20

Systemic reaction (other): Mild pre-existing shoulder ache on non-vaccinated side

Release 4 — days 1–6 daily, dose 1

2021-02-25

Systemic reaction (other): Note this symptom can reasonably be ascribed to toting two sets of twos of 53 and 14 months about as a daycare grandparent

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): If I press on the site I can feel a dull pain that its there; otherwise I dont notice. I keep replying Im fine. But I did have 8 CABG in 2011 that went very well to this day, and I did have an A1c in January of 11.7. Nonetheless I really do feel pretty good at 78.

2021-03-16

Systemic reaction (other): Blah to the point of napping.

2021-03-18

Systemic reaction (other): A dermatology exam Tuesday then a CT ANGIO scan with contrast on Wednesday and our grand childrens (4) Gastro flu last week

Release 6 — day 7, dose 2

2021-03-21

Systemic reaction (other): Turns out I have severe dÃabetic keto acidosis; threw up went to ER and got admitted; sugar level reached 695, then 395, 269, 148, 153, 180, as they turrare to a good level with two IVs and a catheter. Clearly another problem than COVID-19 for which I test negative

Release 7 — day 28, dose 2

2021-04-10

Symptoms: Fever and am in hospital

Release 9 — 3 months, dose 2

2021-06-12

Symptoms: I had a Supra pubic catheter installed and continued my recovery from hospitalizations for DKA Mar 20-23 and Apr 4-15.

Release 9 — 6 months, dose 2

2021-09-11

Symptoms: I got a UTI treated in hospital with IV antibiotics, as result of a urological teat

Release 9 — day 0, dose 3

2021-10-02

Systemic reaction (other): The shot was only 45 minutes ago

Release 11 — 6 months, dose 3

2022-04-03

Symptoms: I have a cold caught from doing daycare for two-year-old twins and maybe their five-year-old twin siblings. My wife (who actually had COVID two months ago, mildly while I did not) and I are both recovering well. Cardiologist says I'm fine etc

Release 12 — 12 months, dose 3

2022-10-02

Symptoms: A nasty traditional cold brought to us by grandchildren twins for whom we do daycare three times weekly or more

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	Bladder catheterisation	·	·	✓
SD	Diabetic ketoacidosis	·	·	✓
SD	Hospitalisation	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Office visit	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Urinary tract infection	·	·	✓
SD	Urine analysis abnormal	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Diabetic ketoacidosis	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hospitalisation	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Vomiting	✓	✓	✓

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