3WP-28777-51101
2 vaccinations
5 coded responses
24 check-ins
5 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 956 / CA
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
-
2021-02-03
Registered in v-safe
-
2021-02-03
Dose 1 — Pfizer-BioNTech
- 2021-02-03
- 2021-02-04
-
2021-02-05
Survey response — days 1–6 daily, dose 1MedDRA: Exposure to SARS-CoV-2, Unevaluable event — Feeling: GoodFree text: I found out today that I was with someone 10 days ago that texted positive. His results were given today but started showing symptoms 8 days ago.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
-
2021-02-24
Dose 2 — Pfizer-BioNTech
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
-
2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Nodule — Feeling: Fair · Joint pains · Be unable to do your normal daily activitiesFree text: Knot in left shoulder from unknown source. May be physical therapy caused.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
-
2021-03-17
Survey response — day 21, dose 2MedDRA: Deep vein thrombosis, Peripheral swelling, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Deep Vein Thrombosis in right leg requiring Xeralto to prevent further clotting. Lrg is severely swollen. I'm scheduled for surgery tomorrow to open and drain abscess in Left shoulder (not injection arm)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-17
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)
- 2021-03-24
- 2021-03-31
- 2021-04-07
-
2021-05-26
Survey response — 3 months, dose 2MedDRA: Deep vein thrombosis, Osteomyelitis, Surgery — Feeling: Fair · Be unable to work, 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 visit, HospitalizationFree text: Symptoms: Deep Vein Thrombosis & Shoulder bone infection. Surgery to remove Humoral Prosthetic and insert spacer for 6 weeks while getting daily antibiotic infusions. · Healthcare visit (other): Surgery & home nursingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-26
Report sent to call center — 3 months, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-08-25
Survey response — 6 months, dose 2MedDRA: Deep vein thrombosis — 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: Persistent DVT in Central Vein in Left Thigh. Taking XARELTO.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-25
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-27
-
2021-08-27
Call successfulReported to VAERS voluntarily prior to GDIT contact
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Pfizer-BioNTech | |
| 2 | 2021-02-24 | Pfizer-BioNTech |
Call center
3 call center cases
3 successful
VAERS report filed, before or during a call: 3
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): I found out today that I was with someone 10 days ago that texted positive. His results were given today but started showing symptoms 8 days ago.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Knot in left shoulder from unknown source. May be physical therapy caused.
Release 5 — day 21, dose 2
Symptoms: Deep Vein Thrombosis in right leg requiring Xeralto to prevent further clotting. Lrg is severely swollen. I'm scheduled for surgery tomorrow to open and drain abscess in Left shoulder (not injection arm)
Release 8 — 3 months, dose 2
Symptoms: Deep Vein Thrombosis & Shoulder bone infection. Surgery to remove Humoral Prosthetic and insert spacer for 6 weeks while getting daily antibiotic infusions.
Healthcare visit (other): Surgery & home nursing
Release 9 — 6 months, dose 2
Symptoms: Persistent DVT in Central Vein in Left Thigh. Taking XARELTO.
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 | Deep vein thrombosis | ✓ | ✓ | ✓ |
| SD | Osteomyelitis | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Exposure to SARS-CoV-2 | ✓ | ✓ | ○ |
| SRO | Nodule | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release