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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

  1. 2020-12-22
    Dose 1 — Pfizer-BioNTech
  2. 2021-01-12
    Dose 2 — Pfizer-BioNTech
  3. 2021-01-15
    Registered in v-safe
  4. 2021-01-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: 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 activities
    Free 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 fingers
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-15
    Report sent to call center — days 1–6 daily, dose 2
    Be unable to work · Be unable to do your normal daily activities
    1 call case(s)
  6. 2021-01-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: 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 consultation
    Free text: I still have pain in the left shoulder area. It has not improved. The pain radiates down my arm on the left side
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-01-17
    Report sent to call center — days 1–6 daily, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  8. 2021-01-18
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pain in extremity — Feeling: Poor · Site: Pain · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities
    Free text: I still haveSevere pain radiating from my left shoulder to my fingers
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-01-18
    Report sent to call center — days 1–6 daily, dose 2
    Be unable to work · Be unable to do your normal daily activities
    1 call case(s)
  10. 2021-01-21
    Survey response — day 7, dose 2
    MedDRA: 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 visit
    Free text: Pain in my entire left upper extremity. Unable to raise my wrist. Loss of strength in my fingers
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-01-21
    Report sent to call center — day 7, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  12. 2021-01-26
    Survey response — day 14, dose 2
    MedDRA: 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 consultation
    Free text: Paralysis of My left arm where I had the vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-01-26
    Report sent to call center — day 14, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  14. 2021-03-18
  15. 2021-03-24
  16. 2021-04-02
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12020-12-22Pfizer-BioNTech
22021-01-12Pfizer-BioNTech

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 2

2021-01-15

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

2021-01-17

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

2021-01-18

Systemic reaction (other): I still haveSevere pain radiating from my left shoulder to my fingers

Release 2 — day 7, dose 2

2021-01-21

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

2021-01-26

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

FieldPreferred term2021-092023-042024-11
SDMonoplegia ✓ ✓ ✓
SROArthralgia ✓ ✓ ✓
SROAsthenia ✓ ✓ ✓
SROMovement disorder ✓ ✓ ✓
SROMusculoskeletal pain ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROParaesthesia ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release