ZS5-26776-45097

3 vaccinations 8 coded responses 37 check-ins 8 free-text entries 1 call case

Sex: Male
Age at first dose: 46-50
ZIP prefix: 974 / OR
Registered: 2021-02-05

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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Pfizer-BioNTech
2021-02-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-22
Dose 2 — Pfizer-BioNTech
2021-02-22
Health check-in — day 0, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Neck pain — Feeling: Good · Joint pains

Free text: Three of us who had our second shot on the same day had a sore neck the last couple days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-08
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-15
Survey response — day 21, dose 2
MedDRA: Blood glucose increased, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Rapidly Increased blood sugar levels. Possibly from Statins, but started those three months ago. Sugars were up gradually until this last week, when they went up drastically without much change in diet. Starting point 160-190... to 466 over 2 wk

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-22
Survey response — day 28, dose 2
MedDRA: Blood glucose increased, Diabetes mellitus inadequate control — Feeling: Fair

Free text: Continued increased blood sugars struggling to control them with increased metformin prescription. Not sure if it has any relationship, but they did increase after the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-23
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-01
Dose 3 — Moderna
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Nausea

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Joint pains

Adult check-in
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Blood glucose increased — Feeling: Good · Site: Pain, Swelling

Free text: Blood glucose levels are elevated more than usual

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Blood glucose increased — Feeling: Fair · Site: Pain · Headache

Free text: Spiking blood glucose levels

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Survey response — days 1–6 daily, dose 3
MedDRA: Blood glucose increased — Feeling: Fair · Diarrhea

Free text: Extremely elevated blood sugar levels

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Survey response — day 7, dose 3
MedDRA: Blood glucose increased — Feeling: Fair · Diarrhea

Free text: Increased blood sugar levels. ( fell slightly, but still elevated since my vaccination)

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-29
Survey response — day 28, dose 3
MedDRA: Blood glucose increased, Diabetes mellitus inadequate control — Feeling: Fair

Free text: Whether or not it's related is subject to determination, but given that it happened with the previous vaccinations, I feel like there is a connnection to my blood sugars being elevated and difficult to control. It occurred after each.

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-21
Call successful
Participant prefers to complete VAERS report online
2022-01-31
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-05-02
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-03
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Pfizer-BioNTech
2	2021-02-22	Pfizer-BioNTech
3	2021-11-01	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-15	Successful 2021-12-21	Participant prefers to complete VAERS report online

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Three of us who had our second shot on the same day had a sore neck the last couple days

Release 5 — day 21, dose 2

2021-03-15

Symptoms: Rapidly Increased blood sugar levels. Possibly from Statins, but started those three months ago. Sugars were up gradually until this last week, when they went up drastically without much change in diet. Starting point 160-190... to 466 over 2 wk cut off by CDC

Release 6 — day 28, dose 2

2021-03-22

Symptoms: Continued increased blood sugars struggling to control them with increased metformin prescription. Not sure if it has any relationship, but they did increase after the vaccine.

Release 10 — days 1–6 daily, dose 3

2021-11-05

Systemic reaction (other): Blood glucose levels are elevated more than usual

2021-11-06

Systemic reaction (other): Spiking blood glucose levels

2021-11-07

Systemic reaction (other): Extremely elevated blood sugar levels

Release 10 — day 7, dose 3

2021-11-08

Systemic reaction (other): Increased blood sugar levels. ( fell slightly, but still elevated since my vaccination)

Release 10 — day 28, dose 3

2021-11-29

Symptoms: Whether or not it's related is subject to determination, but given that it happened with the previous vaccinations, I feel like there is a connnection to my blood sugars being elevated and difficult to control. It occurred after each.

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	Blood glucose increased	✓	✓	✓
SD	Diabetes mellitus inadequate control	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Blood glucose increased	·	·	✓
SRO	Neck pain	✓	✓	✓

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