3JS-11031-40138
2 vaccinations
4 coded responses
8 check-ins
4 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 200 / DC
- Registered
- 2021-02-23
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
-
2021-02-15
Dose 1 — Pfizer-BioNTech
-
2021-02-23
Registered in v-safe
-
2021-02-23
Survey response — day 7, dose 1MedDRA: Pain, Swelling — Feeling: Fair · Fever · Abdominal painFree text: Feeling pain on lower part of my chaste. specially when I am sitting on the chair, feeling like swollen.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-09
Dose 2 — Pfizer-BioNTech
-
2021-03-27
Survey response — day 14, dose 2MedDRA: Abdominal pain upper, Back pain, Cough, Discomfort, Office visit, Throat irritation — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: Symptoms: I feel pain and information / pressure under my ribs and pain in my middle back. I do have a tackling throats and cough sometimes. I dont have a cold symptoms like runy nose. My lungs Are clear. These Pain and pressures are worse when I sit. · Healthcare visit (other): Visit Dr. Too. I am taking 24 hours allergy medication.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-27
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-05
- 2021-04-07
- 2021-04-16
- 2021-04-22
-
2021-09-08
Survey response — 6 months, dose 2MedDRA: Back pain, Costochondritis, Inflammation, Musculoskeletal chest pain, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Pain and inflammation under ribs and middle back. Rash in my body and inflammation around ankle and foot. · Healthcare visit (other): Dr. Visits and CT scanMedDRA releases: 2024-11 · check-in free text available
-
2021-09-08
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-09
- 2021-09-15
-
2021-09-15
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-03-11
Survey response — 12 months, dose 2MedDRA: Back pain, Inflammation, Musculoskeletal chest pain, Office visit — 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 visit, Emergency room or emergency department visitFree text: Symptoms: I have a pain and inflammation under my rib and Middle back. · Healthcare visit (other): Primary Dr. And othersMedDRA releases: 2024-11 · check-in free text available
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2022-03-11
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
-
2022-03-11
Call successfulCompleted over the phone
- 2022-03-14
-
2022-03-14
Callback requested for03:22PM ET
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-15 | Pfizer-BioNTech | |
| 2 | 2021-03-09 | Pfizer-BioNTech |
Call center
3 call center cases
3 successful
VAERS report filed, before or during a call: 1
Free text
Release 4 — day 7, dose 1
Systemic reaction (other): Feeling pain on lower part of my chaste. specially when I am sitting on the chair, feeling like swollen.
Release 6 — day 14, dose 2
Symptoms: I feel pain and information / pressure under my ribs and pain in my middle back. I do have a tackling throats and cough sometimes. I dont have a cold symptoms like runy nose. My lungs Are clear. These Pain and pressures are worse when I sit.
Healthcare visit (other): Visit Dr. Too. I am taking 24 hours allergy medication.
Release 9 — 6 months, dose 2
Symptoms: Pain and inflammation under ribs and middle back. Rash in my body and inflammation around ankle and foot.
Healthcare visit (other): Dr. Visits and CT scan
Release 11 — 12 months, dose 2
Symptoms: I have a pain and inflammation under my rib and Middle back.
Healthcare visit (other): Primary Dr. And others
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 | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Costochondritis | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Discomfort | ✓ | ✓ | ✓ |
| SD | Inflammation | · | · | ✓ |
| SD | Musculoskeletal chest pain | · | · | ✓ |
| SD | Throat irritation | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release