57D-26732-88462
2 vaccinations
3 coded responses
21 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 921 / CA
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-01
Registered in v-safe
-
2021-04-01
Dose 1 — Pfizer-BioNTech
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-08
- 2021-04-15
-
2021-04-22
Dose 2 — Pfizer-BioNTech
- 2021-04-22
- 2021-04-23
- 2021-04-24
- 2021-04-28
- 2021-05-01
- 2021-05-06
- 2021-05-14
- 2021-05-20
- 2021-05-29
- 2021-06-05
-
2021-07-22
Survey response — 3 months, dose 2MedDRA: Arthralgia, Joint range of motion decreased, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Shoulder pain where vaccine was injected. Decreased ROM. · Healthcare visit (other): Im scheduled to see orthopedic doctor.MedDRA releases: 2024-11 · check-in free text available
-
2021-07-22
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-28
-
2021-10-22
Survey response — 6 months, dose 2MedDRA: Office visit, Physiotherapy, Shoulder injury related to vaccine administration — 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 seen an Ortho dr (Dr Kristopher Downing) for SIRVA from my 2nd Covid vaccine on 4/22/21. I received an MRI, a cortisone shot and I am going to PT for my shoulder. I follow-up w/ Dr Downing again in 2wks. Must report officially to VARS and CDC. · Healthcare visit (other): Multiple drs visits, MRIand physical therapyMedDRA releases: 2024-11 · check-in free text available
-
2021-10-22
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)
-
2021-10-25
Call successfulReported to VAERS voluntarily prior to GDIT contact
-
2022-04-24
Survey response — 12 months, dose 2MedDRA: Office visit, Physiotherapy, Shoulder injury related to vaccine administration — Feeling: Good · 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: Saw an orthopedic surgeon and had physical therapy for a shoulder injury from the COVID-19 vaccine. The needle went into my shoulder capsuleMedDRA releases: 2024-11 · check-in free text available
-
2022-04-24
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 · 1 call case(s)
- 2022-04-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Pfizer-BioNTech | |
| 2 | 2021-04-22 | Pfizer-BioNTech |
Call center
3 call center cases
2 successful · 1 unsuccessful
VAERS report filed, before or during a call: 3
Free text
Release 9 — 3 months, dose 2
Symptoms: Shoulder pain where vaccine was injected. Decreased ROM.
Healthcare visit (other): Im scheduled to see orthopedic doctor.
Release 10 — 6 months, dose 2
Symptoms: I have seen an Ortho dr (Dr Kristopher Downing) for SIRVA from my 2nd Covid vaccine on 4/22/21. I received an MRI, a cortisone shot and I am going to PT for my shoulder. I follow-up w/ Dr Downing again in 2wks. Must report officially to VARS and CDC. cut off by CDC
Healthcare visit (other): Multiple drs visits, MRIand physical therapy
Release 11 — 12 months, dose 2
Symptoms: Saw an orthopedic surgeon and had physical therapy for a shoulder injury from the COVID-19 vaccine. The needle went into my shoulder capsule
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 | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Joint range of motion decreased | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Physiotherapy | · | · | ✓ |
| SD | Shoulder injury related to vaccine administration | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release