4K6-16663-00690
3 vaccinations
4 coded responses
31 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 945 / CA
- Registered
- 2021-02-22
- Relationship
- Self
- Race
- Other
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-30
Dose 1 — Pfizer-BioNTech
-
2021-02-22
Registered in v-safe
-
2021-02-22
Dose 2 — Pfizer-BioNTech
- 2021-02-22
- 2021-02-23
- 2021-02-24
-
2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Injected limb mobility decreased — Feeling: GoodFree text: Ever since around the time of my first shot (I think) Ive had trouble raising the arm in one certain position. I really cant recall injuring it and have been wondering if it has anything to do with the shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-26
Survey response — days 1–6 daily, dose 2MedDRA: Pain, Pain in extremity — Feeling: GoodFree text: Still some pain lifting my left arm. Ill be checking in with my DrMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-10
- 2021-03-15
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-05-24
-
2021-08-23
Survey response — 6 months, dose 2MedDRA: Arthralgia, Office visit, Pain, Pain in extremity, 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: Symptoms: I have pain in my left arm that received the injection. The Dr said it may be a irritation from where I got the shot. Ive had physical therapy and at this point there is little improvement.My shoulder is very painful when I try to lift my left elb · Healthcare visit (other): 2 Physical therapy visitsMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-23
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)
-
2021-09-29
Dose 3 — Pfizer-BioNTech
- 2021-09-29
- 2021-09-30
- 2021-10-01
-
2021-10-02
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-03
- 2021-10-04
- 2021-10-05
- 2021-10-06
- 2021-10-14
- 2021-10-20
-
2021-10-27
Survey response — day 28, dose 3MedDRA: Influenza — Feeling: FairFree text: Feel mildly "flu-y"MedDRA releases: 2024-11 · check-in free text available
- 2021-11-05
- 2021-11-10
-
2021-11-19
Call successfulParticipant prefers to complete VAERS report online
- 2021-12-29
- 2022-04-03
- 2022-09-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-30 | Pfizer-BioNTech | |
| 2 | 2021-02-22 | Pfizer-BioNTech | |
| 3 | 2021-09-29 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Ever since around the time of my first shot (I think) Ive had trouble raising the arm in one certain position. I really cant recall injuring it and have been wondering if it has anything to do with the shot
Systemic reaction (other): Still some pain lifting my left arm. Ill be checking in with my Dr
Release 9 — 6 months, dose 2
Symptoms: I have pain in my left arm that received the injection. The Dr said it may be a irritation from where I got the shot. Ive had physical therapy and at this point there is little improvement.My shoulder is very painful when I try to lift my left elb
Healthcare visit (other): 2 Physical therapy visits
Release 10 — day 28, dose 3
Symptoms: Feel mildly "flu-y"
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 | ✓ | · | ✓ |
| HCVO | Physiotherapy | ✓ | · | ✓ |
| SD | Arthralgia | ✓ | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Pain | ✓ | · | ✓ |
| SD | Pain in extremity | ✓ | · | ✓ |
| SD | Physiotherapy | ✓ | · | ✓ |
| SRO | Injected limb mobility decreased | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release