ZAX-33209-31319

3 vaccinations 12 coded responses 21 check-ins 12 free-text entries 4 call cases

Sex: Male
Age at first dose: 26-30
ZIP prefix: 928 / CA
Registered: 2021-06-09

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-06-08
Dose 1 — Pfizer-BioNTech
2021-06-09
Registered in v-safe
2021-06-09
Survey response — days 1–6 daily, dose 1
MedDRA: Hot flush — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Hot flash spots occurring around my body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Survey response — days 1–6 daily, dose 1
MedDRA: Skin warm — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Hot spots randomly along arms, and legs, behind knees, behind buttocks.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-06-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-06-13
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Left lympnode under chin/mandible seems larger than the one on the right. (Enlarged portion appears on the left side same as site of injection.)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-22
Survey response — day 14, dose 1
MedDRA: Condition aggravated, Migraine, Pre-existing disease — Feeling: Fair

Free text: Migraines/higher blood pressure than normal.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-29
Dose 2 — Pfizer-BioNTech
2021-06-29
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Nausea

Adult check-in
2021-07-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-08-05
Survey response — day 35, dose 2
MedDRA: Arthralgia, Limb discomfort, Pain in extremity, Skin warm — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Weird pains in back of knee/started maybe in ankle, up to calf, and now back of knee. Its uncomfortable pain, and felt hot spots randomly as previously mentioned. But, this one, is pain, comes and goes, and sometimes persistent.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-10
Survey response — day 42, dose 2
MedDRA: Arthralgia, Electrocardiogram QRS complex prolonged, Pain, Pain in extremity, Sinus rhythm, Skin warm, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

Free text: Im experiencing SVEs, Sinus Rhythm with Wide QRS, and have been experiencing pains traveling up my leg, starting at calves, upward to behind knees, originally it was hot spots, now its traversed too pain. I have no idea whats going on.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-28
Survey response — 3 months, dose 2
MedDRA: Chest discomfort, Memory impairment, Migraine, Muscle spasms, Temperature regulation disorder, Unevaluable event — 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

Free text: Symptoms: Memory feels off, cant regulate temperature, constant migraines, and chest just feels weird. Random muscle cramps that debilitate you. · Healthcare visit (other): Attempting to get in, is not as easy since Im not old or have a diagnosis of immunocomropised

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Report sent to call center — 3 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)
2021-09-30
Call 1 — Could Not Reach Participant
2021-10-05
Call 2 — Could Not Reach Participant
2021-10-05
Callback requested for
2021-12-31
Dose 3 — Pfizer-BioNTech
2021-12-31
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2022-01-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-03
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-05
Survey response — days 1–6 daily, dose 3
MedDRA: Blood pressure decreased, Bradycardia, Loss of consciousness, Malaise, SARS-CoV-2 test negative, Tachycardia — Feeling: Poor · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Yesterday, I randomly began passing out and my heart rate went into tachycardia & than rapidly descended to Brachycardia my blood pressure also plummeted. Since this, I've not felt good at all. I have tested negative on the 29th of December for covid

MedDRA releases: 2024-11 · check-in free text available
2022-01-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-01-08
Survey response — day 7, dose 3
MedDRA: Blood pressure abnormal, Dizziness, Heart rate abnormal, Syncope — Feeling: Fair · Chills, Nausea

Free text: Dizziness, randomly fainted in an unusual instance. Since blood pressure and heart rate are difficult to manage

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Survey response — day 21, dose 3
MedDRA: Asthenia, Dizziness, Heart rate irregular, Office visit, Syncope — 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

Free text: Symptoms: Heart rate instability, rapidly goes up and down, fainting, dizziness, and weakness · Healthcare visit (other): Visiting a Caridologist, seeking E.R. Care is not possible hospitals aren't permitting equal access and assessing everyone without covid as less than. If needed I'll dial 911

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Report sent to call center — day 21, 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

1 call case(s)
2022-01-24
Call 1 — Left Voicemail
2022-01-28
Survey response — day 28, dose 3
MedDRA: Chills, Dizziness, Feeling cold, Office visit, Palpitations — 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

Free text: Symptoms: Heart palpitations, feeling faint, cold/ chills. · Healthcare visit (other): Visited cardiologist

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Report sent to call center — day 28, 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

1 call case(s)
2022-01-31
Call 1 — Left Voicemail
2022-02-04
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-11
Survey response — day 42, dose 3
MedDRA: Blood pressure increased, Headache, Lethargy, Pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Just general lethargy, headaches, body aches, and sudden increase from my normal blood pressure which has been stable for more than 3+ years

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-08	Pfizer-BioNTech
2	2021-06-29	Pfizer-BioNTech	No
3	2021-12-31	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-05	Unsuccessful
2021-09-28	Unsuccessful
2022-01-21	Unsuccessful
2022-01-28	Unsuccessful

Free text

Release 9 — days 1–6 daily, dose 1

2021-06-09

Systemic reaction (other): Hot flash spots occurring around my body

2021-06-10

Systemic reaction (other): Hot spots randomly along arms, and legs, behind knees, behind buttocks.

2021-06-13

Systemic reaction (other): Left lympnode under chin/mandible seems larger than the one on the right. (Enlarged portion appears on the left side same as site of injection.)

Release 9 — day 14, dose 1

2021-06-22

Symptoms: Migraines/higher blood pressure than normal.

Release 9 — day 35, dose 2

2021-08-05

Symptoms: Weird pains in back of knee/started maybe in ankle, up to calf, and now back of knee. Its uncomfortable pain, and felt hot spots randomly as previously mentioned. But, this one, is pain, comes and goes, and sometimes persistent.

Release 9 — day 42, dose 2

2021-08-10

Symptoms: Im experiencing SVEs, Sinus Rhythm with Wide QRS, and have been experiencing pains traveling up my leg, starting at calves, upward to behind knees, originally it was hot spots, now its traversed too pain. I have no idea whats going on.

Release 9 — 3 months, dose 2

2021-09-28

Symptoms: Memory feels off, cant regulate temperature, constant migraines, and chest just feels weird. Random muscle cramps that debilitate you.

Healthcare visit (other): Attempting to get in, is not as easy since Im not old or have a diagnosis of immunocomropised

Release 10 — days 1–6 daily, dose 3

2022-01-05

Systemic reaction (other): Yesterday, I randomly began passing out and my heart rate went into tachycardia & than rapidly descended to Brachycardia my blood pressure also plummeted. Since this, I've not felt good at all. I have tested negative on the 29th of December for covid cut off by CDC

Release 10 — day 7, dose 3

2022-01-08

Systemic reaction (other): Dizziness, randomly fainted in an unusual instance. Since blood pressure and heart rate are difficult to manage

Release 11 — day 21, dose 3

2022-01-21

Symptoms: Heart rate instability, rapidly goes up and down, fainting, dizziness, and weakness

Healthcare visit (other): Visiting a Caridologist, seeking E.R. Care is not possible hospitals aren't permitting equal access and assessing everyone without covid as less than. If needed I'll dial 911

Release 11 — day 28, dose 3

2022-01-28

Symptoms: Heart palpitations, feeling faint, cold/ chills.

Healthcare visit (other): Visited cardiologist

Release 11 — day 42, dose 3

2022-02-11

Symptoms: Just general lethargy, headaches, body aches, and sudden increase from my normal blood pressure which has been stable for more than 3+ years

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	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	✓	·	✓
SD	Asthenia	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Chills	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Electrocardiogram QRS complex prolonged	✓	·	✓
SD	Feeling cold	·	·	✓
SD	Headache	·	·	✓
SD	Heart rate irregular	·	·	✓
SD	Lethargy	·	·	✓
SD	Limb discomfort	✓	·	✓
SD	Memory impairment	·	·	✓
SD	Migraine	✓	✓	✓
SD	Muscle spasms	·	·	✓
SD	Pain	✓	·	✓
SD	Pain in extremity	✓	·	✓
SD	Palpitations	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sinus rhythm	✓	·	✓
SD	Skin warm	✓	·	✓
SD	Syncope	·	·	✓
SD	Temperature regulation disorder	·	·	✓
SD	Unevaluable event	✓	·	✓
SRO	Blood pressure abnormal	·	·	✓
SRO	Blood pressure decreased	·	·	✓
SRO	Bradycardia	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Heart rate abnormal	·	·	✓
SRO	Hot flush	✓	✓	✓
SRO	Loss of consciousness	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Malaise	·	·	✓
SRO	SARS-CoV-2 test negative	·	·	✓
SRO	Skin warm	✓	✓	✓
SRO	Syncope	·	·	✓
SRO	Tachycardia	·	·	✓

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