69N-85307-17107
2 vaccinations
5 coded responses
5 check-ins
5 free-text entries
5 call cases
- Sex
- Male
- Age at first dose
- 46-50
- ZIP prefix
- 902 / CA
- Registered
- 2021-01-15
- Relationship
- Self
Timeline
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2020-12-22
Dose 1 — Pfizer-BioNTech
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2021-01-12
Dose 2 — Pfizer-BioNTech
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2021-01-15
Registered in v-safe
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2021-01-15
Survey response — days 1–6 daily, dose 2MedDRA: Musculoskeletal pain, Pain, Paraesthesia — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activitiesFree text: I have pain from the Left deltoid region radiating back to the scapula and down my arm. I am experiencing tingling and fasciculations in the left extremity radiating down to my fingersMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-15
Report sent to call center — days 1–6 daily, dose 2Be unable to work · Be unable to do your normal daily activities1 call case(s)
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2021-01-17
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Pain, Pain in extremity — Feeling: Poor · Site: Pain · Joint pains · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I still have pain in the left shoulder area. It has not improved. The pain radiates down my arm on the left sideMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-17
Report sent to call center — days 1–6 daily, 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)
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2021-01-18
Survey response — days 1–6 daily, dose 2MedDRA: Pain in extremity — Feeling: Poor · Site: Pain · Muscle or body aches · Be unable to work, Be unable to do your normal daily activitiesFree text: I still haveSevere pain radiating from my left shoulder to my fingersMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-18
Report sent to call center — days 1–6 daily, dose 2Be unable to work · Be unable to do your normal daily activities1 call case(s)
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2021-01-21
Survey response — day 7, dose 2MedDRA: Asthenia, Movement disorder, Pain in extremity — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches · 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 visitFree text: Pain in my entire left upper extremity. Unable to raise my wrist. Loss of strength in my fingersMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-21
Report sent to call center — day 7, 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)
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2021-01-26
Survey response — day 14, dose 2MedDRA: Monoplegia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Paralysis of My left arm where I had the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-26
Report sent to call center — day 14, 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)
- 2021-03-18
- 2021-03-24
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2021-04-02
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-22 | Pfizer-BioNTech | |
| 2 | 2021-01-12 | Pfizer-BioNTech |
Call center
5 call center cases
5 successful
Free text
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): I have pain from the Left deltoid region radiating back to the scapula and down my arm. I am experiencing tingling and fasciculations in the left extremity radiating down to my fingers
Systemic reaction (other): I still have pain in the left shoulder area. It has not improved. The pain radiates down my arm on the left side
Systemic reaction (other): I still haveSevere pain radiating from my left shoulder to my fingers
Release 2 — day 7, dose 2
Systemic reaction (other): Pain in my entire left upper extremity. Unable to raise my wrist. Loss of strength in my fingers
Release 2 — day 14, dose 2
Symptoms: Paralysis of My left arm where I had the vaccine.
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 | Monoplegia | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Movement disorder | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release