Z87-20892-19816

4 vaccinations 9 coded responses 29 check-ins 9 free-text entries 3 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 840 / UT
Registered: 2021-03-03

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Pfizer-BioNTech
2021-03-03
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Nausea

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Nausea

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Nausea

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Health check-in — day 7, dose 1
Feeling: Good · Headache, Joint pains, Nausea

Adult check-in
2021-03-17
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-24
Dose 2 — Pfizer-BioNTech
2021-03-24
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Muscle or body aches, Nausea

Adult check-in
2021-03-25
Survey response — days 1–6 daily, dose 2
MedDRA: Cold sweat — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Cold sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Peripheral swelling — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Free text: Left side arm and leg swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Nausea

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Headache, Joint pains, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-31
Health check-in — day 7, dose 2
Feeling: Poor · Chills, Headache, Joint pains, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-15
Survey response — day 21, dose 2
MedDRA: Abdominal pain, Muscle spasms — Feeling: Fair · Be unable to do your normal daily activities

Free text: Leg cramp mainly, but in abdomen and back also.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-28
Survey response — day 35, dose 2
MedDRA: Nerve compression — Feeling: Fair

Free text: Feels like a pinched nerve in my neck, but it's not continually hurting.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — day 42, dose 2
MedDRA: Muscle spasms, Neck pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: More cramps and neck pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Survey response — 3 months, dose 2
MedDRA: Blindness unilateral, Visual impairment — 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Vision problems, I lost half of my eyesight in my right eye.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
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)
2021-06-30
Call 1 — Left Voicemail
2021-08-18
Dose 3 — Pfizer-BioNTech
2021-09-22
Survey response — 6 months, dose 2
MedDRA: Blindness, Dizziness, Nausea — 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: Dizziness, nausea, and vision loss. No diagnosis yet.

MedDRA releases: 2024-11 · check-in free text available
2021-09-22
Report sent to call center — 6 months, dose 2
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)
2021-09-29
Call 1 — Left Voicemail
2021-10-01
Survey response — day 42, dose 3
MedDRA: Blindness, Nausea — 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Nausea and vision loss.

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Report sent to call center — day 42, 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 · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-10-04
Call 1 — Could Not Reach Participant
2021-10-07
Call 2 — Left Voicemail
2021-11-18
Health check-in — 3 months, dose 3
Feeling: Poor

Adult check-in
2021-12-23
Dose 4 — Pfizer-BioNTech
2022-02-16
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-06-24
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2022-12-23
Survey response — 12 months, dose 4
MedDRA: Gait disturbance, Gait inability, Pain in extremity, Walking aid user — Feeling: Poor · Be unable to do your normal daily activities

Free text: My Left leg starts hurting every afternoon, it is difficult to walk on for several hours. Also my Left calf hurts so much in the morning that I can't walk on it without crutches.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Pfizer-BioNTech
2	2021-03-24	Pfizer-BioNTech
3	2021-08-18	Pfizer-BioNTech	No
4	2021-12-23	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-23	Unsuccessful
2021-09-22	Unsuccessful
2021-10-01	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-25

Systemic reaction (other): Cold sweats

2021-03-27

Systemic reaction (other): Left side arm and leg swelling

Release 7 — day 21, dose 2

2021-04-15

Symptoms: Leg cramp mainly, but in abdomen and back also.

Release 8 — day 35, dose 2

2021-04-28

Symptoms: Feels like a pinched nerve in my neck, but it's not continually hurting.

Release 8 — day 42, dose 2

2021-05-05

Symptoms: More cramps and neck pain.

Release 9 — 3 months, dose 2

2021-06-23

Symptoms: Vision problems, I lost half of my eyesight in my right eye.

Release 9 — 6 months, dose 2

2021-09-22

Symptoms: Dizziness, nausea, and vision loss. No diagnosis yet.

Release 9 — day 42, dose 3

2021-10-01

Symptoms: Nausea and vision loss.

Release 12 — 12 months, dose 4

2022-12-23

Symptoms: My Left leg starts hurting every afternoon, it is difficult to walk on for several hours. Also my Left calf hurts so much in the morning that I can't walk on it without crutches.

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	Abdominal pain	✓	✓	✓
SD	Blindness	·	·	✓
SD	Blindness unilateral	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Gait disturbance	·	·	✓
SD	Gait inability	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Nausea	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Nerve compression	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Visual impairment	✓	✓	✓
SD	Walking aid user	·	·	✓
SRO	Cold sweat	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓

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