ZDV-15619-76046

2 vaccinations 13 coded responses 21 check-ins 13 free-text entries 1 call case

Sex: Male
Age at first dose: 56-60
ZIP prefix: 221 / VA
Registered: 2020-12-31

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

2020-12-30
Dose 1 — Pfizer-BioNTech
2020-12-31
Registered in v-safe
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Oral pain — Feeling: Fair · Headache

Free text: Pain in the left side of my mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Hypoaesthesia — Feeling: Fair · Chills, Headache, Fatigue or tiredness, Abdominal pain

Free text: Shortness of breath, numbness in extremities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Survey response — day 7, dose 1
MedDRA: Pain in jaw — Feeling: Fair · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Jaw pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — day 14, dose 1
MedDRA: Abdominal pain upper, Headache, Loose tooth — Feeling: Fair

Free text: Stomach cramps, loose teeth, headaches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Dose 2 — Pfizer-BioNTech
2021-01-21
Survey response — day 21, dose 1
MedDRA: Abdominal pain upper, Headache, Rash, Toothache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache, toothache, stomach ache, severe rash.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia, Onychalgia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Fingernails felt like they were being pulled out, numbness in extremities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 2
MedDRA: Visual impairment — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Seeing stars

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work

Free text: Numbness at fingers

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — days 1–6 daily, dose 2
MedDRA: Vision blurred — Feeling: Fair · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work

Free text: Blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — day 7, dose 2
Feeling: Good · Headache, Muscle or body aches · Be unable to work

Adult check-in
2021-02-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-11
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-02-18
Survey response — day 28, dose 2
MedDRA: Headache, Hypoaesthesia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Numbness in the extremities, headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — day 35, dose 2
MedDRA: Abdominal pain upper, Diarrhoea, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Bad stomach cramps, nausea and diarrhea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 42, dose 2
MedDRA: Cellulitis, Emergency care — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cellulitis on left leg - went to hospital emergency room to get treatment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — 3 months, dose 2
MedDRA: Burning sensation, Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Toes hurt - burning sensation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-22
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-06
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Pfizer-BioNTech
2	2021-01-21	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-04-23	Successful 2022-04-06	Participant prefers to complete VAERS report online

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-03

Systemic reaction (other): Pain in the left side of my mouth

2021-01-05

Systemic reaction (other): Shortness of breath, numbness in extremities

Release 1 — day 7, dose 1

2021-01-06

Systemic reaction (other): Jaw pain

Release 2 — day 14, dose 1

2021-01-15

Symptoms: Stomach cramps, loose teeth, headaches.

Release 2 — day 21, dose 1

2021-01-21

Symptoms: Headache, toothache, stomach ache, severe rash.

Release 2 — days 1–6 daily, dose 2

2021-01-23

Systemic reaction (other): Fingernails felt like they were being pulled out, numbness in extremities

2021-01-24

Systemic reaction (other): Seeing stars

2021-01-25

Systemic reaction (other): Numbness at fingers

2021-01-26

Systemic reaction (other): Blurry vision

Release 4 — day 28, dose 2

2021-02-18

Symptoms: Numbness in the extremities, headaches

Release 4 — day 35, dose 2

2021-02-25

Symptoms: Bad stomach cramps, nausea and diarrhea.

Release 5 — day 42, dose 2

2021-03-04

Symptoms: Cellulitis on left leg - went to hospital emergency room to get treatment

Release 7 — 3 months, dose 2

2021-04-23

Symptoms: Toes hurt - burning sensation

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 upper	✓	✓	✓
SD	Burning sensation	✓	✓	✓
SD	Cellulitis	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Loose tooth	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Toothache	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Onychalgia	✓	✓	✓
SRO	Oral pain	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Vision blurred	✓	✓	✓
SRO	Visual impairment	✓	✓	✓

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