ZNU-33157-14257

3 vaccinations 10 coded responses 37 check-ins 9 free-text entries 5 call cases

Sex: Male
Age at first dose: 66+
ZIP prefix: 631 / MO
Registered: 2021-02-10

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-02-10
Registered in v-safe
2021-02-10
Dose 1 — Pfizer-BioNTech
2021-02-10
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-03
Dose 2 — Pfizer-BioNTech
2021-03-03
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling cold — Feeling: Fair

Free text: I feel cold

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-11
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-02
Survey response — 3 months, dose 2
MedDRA: Eye swelling — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: I have a bite on my forehead and my eye is swollen I dont think its because of the vaccine additionally I had prostate surgery two weeks ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-01
Survey response — 6 months, dose 2
MedDRA: Anaphylactic reaction, Prostate cancer, Radiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Had anaphylactic experience after aCT. First time. Began radiation trmt for prostate CA

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-01
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-03
Call 2 — Left Voicemail
2022-03-05
Survey response — 12 months, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Getting weaker from the cancer treatment

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Dose 3 — Pfizer-BioNTech
2022-04-22
Health check-in — day 0, dose 3
Feeling: Fair · None

Adult check-in
2022-04-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2022-04-24
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-04-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2022-04-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2022-04-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-29
Survey response — day 7, dose 3
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Yesterday I received my fourth Covid injection

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Survey response — day 14, dose 3
MedDRA: Fatigue, Hot flush — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tired and many "Hot Flashes"

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Survey response — day 21, dose 3
MedDRA: Arthralgia, Bone cancer — Feeling: Poor · Be unable to do your normal daily activities

Free text: Hip cancer pain

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-05-28
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-06-03
Survey response — day 42, dose 3
MedDRA: Neoplasm malignant — 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

Free text: Cancer related symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
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 · 1 call case(s)
2022-06-06
Call 1 — Left Voicemail
2022-06-06
Call 1 — Left Voicemail
2022-06-06
Call 1 — Left Voicemail
2022-06-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-10-21
Survey response — 6 months, dose 3
MedDRA: Neoplasm malignant — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: These are not related to Covid injection but due to my cancer diagnosis

MedDRA releases: 2024-11 · check-in free text available
2022-10-21
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)
2022-10-24
Call 2 — Left Voicemail
2023-04-22
Survey response — 12 months, dose 3
MedDRA: Gait inability — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

MedDRA releases: 2024-11
2023-04-22
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2023-04-24
Call 1 — Left Voicemail
2023-04-24
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-10	Pfizer-BioNTech
2	2021-03-03	Pfizer-BioNTech
3	2022-04-22	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-02	Successful 2022-06-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-01	Successful 2022-06-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-03	Successful 2022-06-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-21	Unsuccessful
2023-04-22	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): I feel cold

Release 8 — 3 months, dose 2

2021-06-02

Symptoms: I have a bite on my forehead and my eye is swollen I dont think its because of the vaccine additionally I had prostate surgery two weeks ago

Release 9 — 6 months, dose 2

2021-09-01

Symptoms: Had anaphylactic experience after aCT. First time. Began radiation trmt for prostate CA

Release 11 — 12 months, dose 2

2022-03-05

Symptoms: Getting weaker from the cancer treatment

Release 11 — day 7, dose 3

2022-04-29

Systemic reaction (other): Yesterday I received my fourth Covid injection

Release 11 — day 14, dose 3

2022-05-06

Symptoms: Tired and many "Hot Flashes"

Release 11 — day 21, dose 3

2022-05-16

Symptoms: Hip cancer pain

Release 11 — day 42, dose 3

2022-06-03

Symptoms: Cancer related symptoms

Release 12 — 6 months, dose 3

2022-10-21

Symptoms: These are not related to Covid injection but due to my cancer diagnosis

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	Anaphylactic reaction	✓	·	✓
SD	Arthralgia	·	·	✓
SD	Bone cancer	·	·	✓
SD	Eye swelling	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Gait inability	·	·	✓
SD	Hot flush	·	·	✓
SD	Neoplasm malignant	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Prostate cancer	✓	·	✓
SD	Radiotherapy	✓	·	✓
SRO	Feeling cold	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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