ZCK-25583-64045

2 vaccinations 14 coded responses 23 check-ins 14 free-text entries 8 call cases

Sex: Male
Age at first dose: 36-40
ZIP prefix: 334 / FL
Registered: 2021-04-22

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

2021-04-22
Registered in v-safe
2021-04-22
Dose 1 — Pfizer-BioNTech
2021-04-22
Survey response — day 0, dose 1
MedDRA: Pain in extremity — Feeling: Good

Free text: Pain in leg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain — Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Pain near my heart/side of body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 1
MedDRA: Blood pressure increased, Emergency care, Hypertension — Feeling: Fair · Site: Pain · Chills, Headache, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Pulse shot up to 150, and BP was 170/120 at 9pm last night. Had to go to ER. They did X-ray and blood work. Bp at hospital was 185/117.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-25
Survey response — days 1–6 daily, dose 1
MedDRA: Cardiac disorder, Heart rate increased, Hypertension, Medical counselling, Pre-existing disease — Feeling: Poor · Chills, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Had the same cardiac issues as prior night. And at the same exact time 9-10pm - heart rate went up to 150bpm. And pulse went to 173/119!! Called my dr and they said to go to hospital. I cant afford another ER copay so I waited and tried to calm myself or relax, walked around a bit. And by midnight I felt ok - pluse was still 90bpm before I went to bed. Why are these cardiac events happening?? Does the vaccine cause my Metoprolol or eliquis to be less effective? Nothing like this has happened before. I have a blood clot in my leg and Im worried its going to come loose because of the high BP and pulse. Please call/help.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-26
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling jittery, Headache, Neck pain — Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Feeling Jittery and have a weird pain in my neck, where it meets my head. On the left side. Same side as shot was administered.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-27
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Palpitations — Feeling: Poor · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Extreme palpitations with back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Report sent to call center — days 1–6 daily, dose 1
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)
2021-04-28
Survey response — days 1–6 daily, dose 1
MedDRA: Palpitations — Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: PALPITATIONS BAD

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Survey response — day 7, dose 1
MedDRA: Palpitations — Feeling: Fair · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: PALPITATIONS

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — day 7, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Survey response — day 14, dose 1
MedDRA: Cardiac disorder, Heart rate increased — Feeling: Fair · 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: Heart issues - rapid pulse 150 bpm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-13
Dose 2 — Pfizer-BioNTech
2021-05-13
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Angina pectoris, Chest pain — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Heart chest pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia — Feeling: Fair

Free text: Numb arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-05-20
Health check-in — day 7, dose 2
Feeling: Good · Diarrhea, Abdominal pain

Adult check-in
2021-05-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-03
Survey response — day 21, dose 2
MedDRA: Chromaturia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Urine is extremely YELLOW ALMOST BROWN. Are my kidneys shutting down??

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-10
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-17
Survey response — day 35, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

Free text: Possible blood clotting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-12
Survey response — 3 months, dose 2
MedDRA: Ophthalmic migraine — Feeling: Fair · Be unable to do your normal daily activities

Free text: Had to go on Eliquis due to clotting concerns. Also experienced ocular migraines

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-29
Call 2 — Could Not Reach Participant
2022-01-04
Call 1 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-22	Pfizer-BioNTech
2	2021-05-13	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-04-24	Unsuccessful
2021-04-25	Unsuccessful
2021-04-26	Unsuccessful
2021-04-27	Unsuccessful
2021-04-28	Unsuccessful
2021-04-29	Unsuccessful
2021-05-06	Unsuccessful
2021-06-03	Unsuccessful

Free text

Release 7 — day 0, dose 1

2021-04-22

Systemic reaction (other): Pain in leg

Release 7 — days 1–6 daily, dose 1

2021-04-23

Systemic reaction (other): Pain near my heart/side of body

2021-04-24

Systemic reaction (other): Pulse shot up to 150, and BP was 170/120 at 9pm last night. Had to go to ER. They did X-ray and blood work. Bp at hospital was 185/117.

2021-04-25

Systemic reaction (other): Had the same cardiac issues as prior night. And at the same exact time 9-10pm - heart rate went up to 150bpm. And pulse went to 173/119!! Called my dr and they said to go to hospital. I cant afford another ER copay so I waited and tried to calm myself or relax, walked around a bit. And by midnight I felt ok - pluse was still 90bpm before I went to bed. Why are these cardiac events happening?? Does the vaccine cause my Metoprolol or eliquis to be less effective? Nothing like this has happened before. I have a blood clot in my leg and Im worried its going to come loose because of the high BP and pulse. Please call/help.

Release 8 — days 1–6 daily, dose 1

2021-04-26

Systemic reaction (other): Feeling Jittery and have a weird pain in my neck, where it meets my head. On the left side. Same side as shot was administered.

2021-04-27

Systemic reaction (other): Extreme palpitations with back pain

2021-04-28

Systemic reaction (other): PALPITATIONS BAD

Release 8 — day 7, dose 1

2021-04-29

Systemic reaction (other): PALPITATIONS

Release 8 — day 14, dose 1

2021-05-06

Symptoms: Heart issues - rapid pulse 150 bpm

Release 8 — days 1–6 daily, dose 2

2021-05-14

Systemic reaction (other): Heart chest pain

2021-05-18

Systemic reaction (other): Numb arm

Release 8 — day 21, dose 2

2021-06-03

Symptoms: Urine is extremely YELLOW ALMOST BROWN. Are my kidneys shutting down??

Release 9 — day 35, dose 2

2021-06-17

Symptoms: Possible blood clotting

Release 9 — 3 months, dose 2

2021-08-12

Symptoms: Had to go on Eliquis due to clotting concerns. Also experienced ocular migraines

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	Cardiac disorder	✓	✓	✓
SD	Chromaturia	✓	✓	✓
SD	Heart rate increased	✓	✓	✓
SD	Ophthalmic migraine	✓	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Angina pectoris	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Blood pressure increased	✓	✓	✓
SRO	Cardiac disorder	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Feeling jittery	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Hypertension	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Medical counselling	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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