ZY8-28266-78577

2 vaccinations 7 coded responses 14 check-ins 7 free-text entries 4 call cases

Sex: Male
Age at first dose: 56-60
ZIP prefix: 463 / IN
Registered: 2021-07-11

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

2021-07-09
Dose 1 — Pfizer-BioNTech
2021-07-11
Registered in v-safe
2021-07-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-07-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-07-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-07-16
Health check-in — day 7, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-07-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-07-30
Dose 2 — Pfizer-BioNTech
2021-08-06
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-08-13
Survey response — day 14, dose 2
MedDRA: Heart rate increased, Office visit — 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 · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Ha e issue with my heart rate going from 54 bpm to 131 bpm · Healthcare visit (other): Heart doctor

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-13
Report sent to call center — day 14, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-20
Survey response — day 21, dose 2
MedDRA: Asthenia, Cardiac disorder, Fatigue, Injection site pain, Office visit — Feeling: Poor · 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: Symptoms: More issues with my heart and having pain at the injection site. Feel drained and tired all the time. · Healthcare visit (other): Heart doctor

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-20
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-20
Call successful
Participant prefers to complete VAERS report online
2021-08-24
Call 1 — Could Not Reach Participant
2021-08-29
Survey response — day 28, dose 2
MedDRA: Feeling abnormal, Hypoaesthesia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Numbness in my left are from my shoulder to my elbow. Feeling not myself.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-29
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-02
Call 1 — Left Voicemail
2021-09-03
Survey response — day 35, dose 2
MedDRA: Hypoaesthesia — Feeling: Fair

Free text: Numbness in the left arm is now going down to the left wrist

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-10
Survey response — day 42, dose 2
MedDRA: Asthenia, Hypoaesthesia — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: More numbness in left arm and ha I got issue with feeling week.

MedDRA releases: 2024-11 · check-in free text available
2021-09-10
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-14
Call 1 — Left Voicemail
2021-10-29
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2022-01-28
Survey response — 6 months, dose 2
MedDRA: Injection site mass, Neoplasm, Office visit, Ultrasound scan abnormal — Feeling: Poor · Be unable to do your normal daily activities

Free text: After my first Covid injection I developed a lump on my left arm at injection site. Was told to put ice on it I had an ultrasound and it ended up being a tumor in my arm I've had a MRI since then and seeing a neurologist may need surgery to remove

MedDRA releases: 2024-11 · check-in free text available
2022-07-30
Survey response — 12 months, dose 2
MedDRA: Impaired work ability, Injection site mass, Neoplasm, Tumour excision, Ultrasound scan abnormal — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: After my first COVID vacation I developed a lump on my shoulder at the injection site after months of being told it would go away I had a ultrasound done on my are and a tumor was found. I had surgery to remove it and been off work for almost 6 month

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-09	Pfizer-BioNTech	No
2	2021-07-30	Pfizer-BioNTech	No

Call center

4 call center cases

1 successful · 3 unsuccessful

See the call center timeline

Free text

Release 9 — day 14, dose 2

2021-08-13

Symptoms: Ha e issue with my heart rate going from 54 bpm to 131 bpm

Healthcare visit (other): Heart doctor

Release 9 — day 21, dose 2

2021-08-20

Symptoms: More issues with my heart and having pain at the injection site. Feel drained and tired all the time.

Healthcare visit (other): Heart doctor

Release 9 — day 28, dose 2

2021-08-29

Symptoms: Numbness in my left are from my shoulder to my elbow. Feeling not myself.

Release 9 — day 35, dose 2

2021-09-03

Symptoms: Numbness in the left arm is now going down to the left wrist

Release 9 — day 42, dose 2

2021-09-10

Symptoms: More numbness in left arm and ha I got issue with feeling week.

Release 11 — 6 months, dose 2

2022-01-28

Symptoms: After my first Covid injection I developed a lump on my left arm at injection site. Was told to put ice on it I had an ultrasound and it ended up being a tumor in my arm I've had a MRI since then and seeing a neurologist may need surgery to remove

Release 12 — 12 months, dose 2

2022-07-30

Symptoms: After my first COVID vacation I developed a lump on my shoulder at the injection site after months of being told it would go away I had a ultrasound done on my are and a tumor was found. I had surgery to remove it and been off work for almost 6 month cut off by CDC

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	Office visit	✓	·	✓
SD	Asthenia	✓	·	✓
SD	Cardiac disorder	✓	·	✓
SD	Fatigue	✓	·	✓
SD	Feeling abnormal	✓	·	✓
SD	Heart rate increased	✓	·	✓
SD	Hypoaesthesia	✓	·	✓
SD	Impaired work ability	·	·	✓
SD	Injection site mass	·	·	✓
SD	Injection site pain	✓	·	✓
SD	Neoplasm	·	·	✓
SD	Office visit	·	·	✓
SD	Tumour excision	·	·	✓
SD	Ultrasound scan abnormal	·	·	✓

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