4TN-69809-62551
5 vaccinations
4 coded responses
47 check-ins
4 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 461 / IN
- Registered
- 2021-01-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-05
Registered in v-safe
-
2021-01-05
Dose 1 — Pfizer-BioNTech
- 2021-01-05
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-19
-
2021-01-26
Dose 2 — Pfizer-BioNTech
- 2021-01-26
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
-
2021-02-02
Survey response — day 7, dose 2MedDRA: Office visit, Unevaluable event — Feeling: Fair · Site: Pain · Muscle or body aches · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): I believe the cause of the pain is a torn rotator cuff, 2 yr old injury that flared up, unknown if related to the covid shot, dont believe so. · Healthcare visit (other): Orthopedic doctor visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-02
Report sent to call center — day 7, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-09
-
2021-02-16
Survey response — day 21, dose 2MedDRA: Myalgia, Office visit — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: 2nd injection are has excruciating pain radiating to my back and neck, xrays taken negative results, orthopedic surgeon thinks it maybe muscle in my neck, i have a chiropractor appt for Thursday to try to get yhe pain stopped · Healthcare visit (other): Primary dr, ortho dr, chiropractorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-16
Report sent to call center — day 21, 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)
-
2021-02-23
Survey response — day 28, dose 2MedDRA: Neck pain, Nerve compression — Feeling: FairFree text: My pain turned out to be pinched nerve in neck nothing to do with shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
- 2021-03-09
- 2021-04-27
-
2021-06-16
Call successfulDoes not wish to fill out VAERS report
- 2021-07-27
-
2021-09-25
Dose 3 — Pfizer-BioNTech
- 2021-09-30
- 2021-10-01
- 2021-10-02
- 2021-10-09
- 2021-10-16
- 2021-10-23
- 2021-10-30
-
2021-12-25
Survey response — 3 months, dose 3MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
-
2022-03-07
Dose 4 — Pfizer-BioNTech
- 2022-03-26
- 2022-04-15
- 2022-04-18
- 2022-06-06
- 2022-09-05
-
2022-09-26
Dose 5 — Pfizer-BioNTechCo-administered: Flu
- 2022-09-30
- 2022-10-01
- 2022-10-02
- 2022-10-03
- 2022-10-10
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-11-07
- 2022-12-26
- 2023-03-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Pfizer-BioNTech | |
| 2 | 2021-01-26 | Pfizer-BioNTech | |
| 3 | 2021-09-25 | Pfizer-BioNTech | No |
| 4 | 2022-03-07 | Pfizer-BioNTech | No |
| 5 | 2022-09-26 | Pfizer-BioNTech | Flu |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 3 — day 7, dose 2
Systemic reaction (other): I believe the cause of the pain is a torn rotator cuff, 2 yr old injury that flared up, unknown if related to the covid shot, dont believe so.
Healthcare visit (other): Orthopedic doctor visit
Release 4 — day 21, dose 2
Symptoms: 2nd injection are has excruciating pain radiating to my back and neck, xrays taken negative results, orthopedic surgeon thinks it maybe muscle in my neck, i have a chiropractor appt for Thursday to try to get yhe pain stopped
Healthcare visit (other): Primary dr, ortho dr, chiropractor
Release 4 — day 28, dose 2
Symptoms: My pain turned out to be pinched nerve in neck nothing to do with shot
Release 10 — 3 months, dose 3
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 | Myalgia | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Nerve compression | ✓ | ✓ | ✓ |
| SD | No adverse event | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release