3GU-48611-86456
3 vaccinations
2 coded responses
26 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 117 / NY
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-29
Registered in v-safe
-
2021-01-29
Dose 1 — Pfizer-BioNTech
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-12
-
2021-02-19
Dose 2 — Pfizer-BioNTech
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
-
2021-03-05
Survey response — day 14, dose 2MedDRA: Arthralgia — Feeling: GoodFree text: Shoulder pain when raising arm near the injection site. MRI possibly shows bursitis. This started after the first shot. Didn't report previously, didnt make connection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-12
Survey response — day 21, dose 2MedDRA: Arthralgia, Bursitis, Office visit, Periarthritis — 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 consultationFree text: Shoulder pain which actually started just after first vac. After Ortho visit and MRI, I appear to have developed a slight bursitis and adhesive capsulitis in the joint. Apparently, this is not uncommon, orthopedist mentioned he has been seeing this.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-12
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-19
- 2021-03-26
- 2021-04-03
- 2021-05-23
- 2021-08-20
-
2021-09-27
Dose 3 — Pfizer-BioNTech
- 2021-10-01
- 2021-10-03
-
2022-03-02
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-29 | Pfizer-BioNTech | |
| 2 | 2021-02-19 | Pfizer-BioNTech | |
| 3 | 2021-09-27 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 5 — day 14, dose 2
Symptoms: Shoulder pain when raising arm near the injection site. MRI possibly shows bursitis. This started after the first shot. Didn't report previously, didnt make connection.
Release 5 — day 21, dose 2
Symptoms: Shoulder pain which actually started just after first vac. After Ortho visit and MRI, I appear to have developed a slight bursitis and adhesive capsulitis in the joint. Apparently, this is not uncommon, orthopedist mentioned he has been seeing this. 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 |
|---|---|---|---|---|
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Bursitis | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Periarthritis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release