ZG6-19139-32317

4 vaccinations 7 coded responses 37 check-ins 7 free-text entries 2 call cases

Sex: Male
Age at first dose: 61-65
ZIP prefix: 295 / SC
Registered: 2021-01-08

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

2021-01-08
Registered in v-safe
2021-01-08
Dose 1 — Pfizer-BioNTech
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Dose 2 — Pfizer-BioNTech
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain, Pain in extremity — Feeling: Good · Site: Pain

Free text: left arm where got 1 st shot 3 wks prior started to hurt again 2 hrs after I got the second shot in the Rt shoulder / took severa hours more bedore the right deltoid started to hurt also. both resolved about 3 days later but varied as to which side hurt more at a given time. Curious, tho not shocking.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Nausea

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Nausea, Diarrhea

Adult check-in
2021-02-14
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-19
Survey response — day 14, dose 2
MedDRA: Headache — Feeling: Good

Free text: headache yesterday evening and all night - now resolved

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-25
Dose 3 — Pfizer-BioNTech
2021-09-30
Survey response — days 1–6 daily, dose 3
MedDRA: No adverse event — Feeling: Good

Free text: no

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-02
Survey response — day 7, dose 3
MedDRA: No adverse event — Feeling: Good

Free text: no

MedDRA releases: 2024-11 · check-in free text available
2021-10-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-30
Survey response — day 35, dose 3
MedDRA: Diarrhoea — Feeling: Good

Free text: diarrhea most days over the past week - no other new symptoms

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-26
Survey response — 6 months, dose 3
MedDRA: Blood pressure increased — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: elevated blood oressures

MedDRA releases: 2024-11 · check-in free text available
2022-03-26
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-29
Call 1 — Left Voicemail
2022-04-23
Dose 4 — Pfizer-BioNTech
2022-05-15
Survey response — day 21, dose 4
MedDRA: Catheterisation cardiac abnormal, Coronary arterial stent insertion, Coronary artery occlusion, Fibromuscular dysplasia, Hospitalisation, Hypertension, Pre-existing disease — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: 1) Hypertension - needed meds adjusted to better control 2) underwent left heart cath Apr 13 with Dx 60% LAD lesion which was stented. Asymptomatic since ( and only atypical symptoms prior but very strong recent FMH). · Healthcare visit (other): overnight stay after heart cath

MedDRA releases: 2024-11 · check-in free text available
2022-05-15
Report sent to call center — day 21, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2022-05-16
Call 2 — Left Voicemail
2022-05-16
Call 1 — Left Voicemail
2022-05-16
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-16
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-21
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-28
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-04
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-23
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-23
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Pfizer-BioNTech
2	2021-02-05	Pfizer-BioNTech
3	2021-09-25	Pfizer-BioNTech	No
4	2022-04-23	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-03-26	Successful 2022-05-16	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-15	Successful 2022-05-16	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-08

Systemic reaction (other): left arm where got 1 st shot 3 wks prior started to hurt again 2 hrs after I got the second shot in the Rt shoulder / took severa hours more bedore the right deltoid started to hurt also. both resolved about 3 days later but varied as to which side hurt more at a given time. Curious, tho not shocking.

Release 4 — day 14, dose 2

2021-02-19

Symptoms: headache yesterday evening and all night - now resolved

Release 9 — days 1–6 daily, dose 3

2021-09-30

Systemic reaction (other): no

Release 9 — day 7, dose 3

2021-10-02

Systemic reaction (other): no

Release 10 — day 35, dose 3

2021-10-30

Symptoms: diarrhea most days over the past week - no other new symptoms

Release 11 — 6 months, dose 3

2022-03-26

Symptoms: elevated blood oressures

Release 11 — day 21, dose 4

2022-05-15

Symptoms: 1) Hypertension - needed meds adjusted to better control 2) underwent left heart cath Apr 13 with Dx 60% LAD lesion which was stented. Asymptomatic since ( and only atypical symptoms prior but very strong recent FMH).

Healthcare visit (other): overnight stay after heart cath

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	Hospitalisation	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Catheterisation cardiac abnormal	·	·	✓
SD	Coronary arterial stent insertion	·	·	✓
SD	Coronary artery occlusion	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fibromuscular dysplasia	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypertension	·	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Pain in extremity	✓	✓	✓

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