3FS-30372-72175
3 vaccinations
9 coded responses
32 check-ins
9 free-text entries
5 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 294 / SC
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Pfizer-BioNTech
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-22
- 2021-01-29
-
2021-02-04
Dose 2 — Pfizer-BioNTech
- 2021-02-04
- 2021-02-05
- 2021-02-06
-
2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Erythema — Feeling: GoodFree text: Minor. Reddish hands and feet sometimes. No pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-05-06
- 2021-08-05
-
2021-09-22
Dose 3 — Pfizer-BioNTech
- 2021-09-27
-
2021-09-28
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pain — Feeling: Fair · Muscle or body achesFree text: Pain in arm near injection siteMedDRA releases: 2024-11 · check-in free text available
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2021-09-29
Survey response — day 7, dose 3MedDRA: Injection site pain — Feeling: Fair · Muscle or body achesFree text: Pain in arm around injection site.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-06
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2021-10-13
Survey response — day 21, dose 3MedDRA: Arthralgia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Pain in right shoulder. Injection in right shoulder.MedDRA releases: 2024-11 · check-in free text available
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2021-10-13
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2021-10-20
Survey response — day 28, dose 3MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Pain in shoulder of injection arm. Very painful.MedDRA releases: 2024-11 · check-in free text available
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2021-10-20
Report sent to call center — day 28, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-10-22
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2021-10-22
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2021-10-27
Survey response — day 35, dose 3MedDRA: Arthralgia, Bursitis, Office visit — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Pain in shoulder above injection site. Orthopedic surgeon says the shot caused bursitis. Cortisone shot hasn't helped pain.MedDRA releases: 2024-11 · check-in free text available
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2021-11-03
Survey response — day 42, dose 3MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Increasing Pain in shoulder above injection site.MedDRA releases: 2024-11 · check-in free text available
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2021-11-03
Report sent to call center — day 42, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-11-05
Call successfulDoes not wish to fill out VAERS report
- 2021-12-22
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2022-03-16
Call successfulReported to VAERS voluntarily prior to GDIT contact
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2022-03-23
Survey response — 6 months, dose 3MedDRA: Rotator cuff repair, Surgery — 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 visitFree text: Symptoms: Had to have rotator cuff surgery · Healthcare visit (other): Outpatient surgeryMedDRA releases: 2024-11 · check-in free text available
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2022-03-23
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-03-24
- 2022-03-29
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2022-09-22
Survey response — 12 months, dose 3MedDRA: Shoulder operation — Feeling: Fair · Get care from a doctor or other healthcare professional · HospitalizationFree text: Because of the booster shot I required shoulder surgery. No faith in these shots.MedDRA releases: 2024-11 · check-in free text available
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2022-09-22
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
- 2022-09-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Pfizer-BioNTech | |
| 2 | 2021-02-04 | Pfizer-BioNTech | |
| 3 | 2021-09-22 | Pfizer-BioNTech | No |
Call center
5 call center cases
4 successful · 1 unsuccessful
VAERS report filed, before or during a call: 1
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Minor. Reddish hands and feet sometimes. No pain.
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Pain in arm near injection site
Release 9 — day 7, dose 3
Systemic reaction (other): Pain in arm around injection site.
Release 10 — day 21, dose 3
Symptoms: Pain in right shoulder. Injection in right shoulder.
Release 10 — day 28, dose 3
Symptoms: Pain in shoulder of injection arm. Very painful.
Release 10 — day 35, dose 3
Symptoms: Pain in shoulder above injection site. Orthopedic surgeon says the shot caused bursitis. Cortisone shot hasn't helped pain.
Release 10 — day 42, dose 3
Symptoms: Increasing Pain in shoulder above injection site.
Release 11 — 6 months, dose 3
Release 12 — 12 months, dose 3
Symptoms: Because of the booster shot I required shoulder surgery. No faith in these shots.
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 | Surgery | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Bursitis | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Rotator cuff repair | · | · | ✓ |
| SD | Shoulder operation | · | · | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release