3VX-20793-06364
2 vaccinations
8 coded responses
22 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 391 / MS
- Registered
- 2021-06-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-06-22
Dose 1 — Pfizer-BioNTech
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2021-06-23
Registered in v-safe
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2021-06-24
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-06-25
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-06-26
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Back pain, Chest pain, Injection site pain, Pain, Pain in extremity — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Intense pain radiated from the injection site on my left shoulder down my arm and into my back and chest on the left side last night.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-27
- 2021-06-28
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2021-06-29
Survey response — day 7, dose 1MedDRA: Pain — Feeling: Good · Site: Pain · Muscle or body achesFree text: Significant pain in shoulder when lift my armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-06
Survey response — day 14, dose 1MedDRA: Headache, Nausea — Feeling: Good · Be unable to do your normal daily activitiesFree text: NauseaHeadachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-13
Survey response — day 21, dose 1MedDRA: Arthralgia, Injection site pain, Mobility decreased, Pain in extremity, Sleep disorder — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Pain in my left arm from the injection site at my shoulder down to my wrist. Im unable to move my arm in certain positions or sleep on my left side because of the pain in my arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-18
Dose 2 — Pfizer-BioNTech
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2021-07-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-07-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-07-22
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-07-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-07-24
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · None · Be unable to do your normal daily activitiesAdult check-in
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2021-07-25
Health check-in — day 7, dose 2Feeling: Good · Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-08-03
Survey response — day 14, dose 2MedDRA: Asthenia, Injection site pain, Nausea, Tachycardia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Severe pain in left shoulder where I had vaccine. Tachycardia with nausea and weaknessMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-08
Survey response — day 21, dose 2MedDRA: Pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: General aches all overMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-15
Survey response — day 28, dose 2MedDRA: Diarrhoea, Injection site pain, Nausea, Vomiting — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Severe pain in left shoulder injection siteNausea and vomiting DiarrheaMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-08-22
- 2021-08-29
- 2021-10-17
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2022-01-16
Survey response — 6 months, dose 2MedDRA: Arthralgia, Joint range of motion decreased, Office visit, Periarthritis, Physiotherapy — 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: Substantial pain in L shoulder where vaccine was administered. Significant pain continued as well as decreased ROM. Required MD appt. Diagnosed frozen shoulder. Required cortisone injection and physical therapy.MedDRA releases: 2024-11 · check-in free text available
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2022-01-16
Report sent to call center — 6 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 · 1 call case(s)
- 2022-01-18
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2022-01-18
Call successfulCompleted over the phone
- 2022-07-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-22 | Pfizer-BioNTech | No |
| 2 | 2021-07-18 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Intense pain radiated from the injection site on my left shoulder down my arm and into my back and chest on the left side last night.
Release 9 — day 7, dose 1
Systemic reaction (other): Significant pain in shoulder when lift my arm
Release 9 — day 14, dose 1
Symptoms: NauseaHeadaches
Release 9 — day 21, dose 1
Symptoms: Pain in my left arm from the injection site at my shoulder down to my wrist. Im unable to move my arm in certain positions or sleep on my left side because of the pain in my arm.
Release 9 — day 14, dose 2
Symptoms: Severe pain in left shoulder where I had vaccine. Tachycardia with nausea and weakness
Release 9 — day 21, dose 2
Symptoms: General aches all over
Release 9 — day 28, dose 2
Symptoms: Severe pain in left shoulder injection siteNausea and vomiting Diarrhea
Release 10 — 6 months, dose 2
Symptoms: Substantial pain in L shoulder where vaccine was administered. Significant pain continued as well as decreased ROM. Required MD appt. Diagnosed frozen shoulder. Required cortisone injection and physical therapy.
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 | Asthenia | ✓ | · | ✓ |
| SD | Diarrhoea | ✓ | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Joint range of motion decreased | · | · | ✓ |
| SD | Mobility decreased | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pain | ✓ | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Periarthritis | · | · | ✓ |
| SD | Physiotherapy | · | · | ✓ |
| SD | Sleep disorder | ✓ | ✓ | ✓ |
| SD | Tachycardia | ✓ | · | ✓ |
| SD | Vomiting | ✓ | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release