6MJ-29402-96489

3 vaccinations 18 coded responses 25 check-ins 18 free-text entries 1 call case

Sex: Male
Age at first dose: 66+
ZIP prefix: 325 / FL
Registered: 2020-12-28

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-28
Registered in v-safe
2020-12-28
Dose 1 — Pfizer-BioNTech
2020-12-28
Survey response — day 0, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: Sore arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2020-12-30
Survey response — days 1–6 daily, dose 1
MedDRA: Myalgia — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: My muscle at left hip hurts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: Left hip mussel pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Flank pain, Sleep disorder — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: Muscle aches lower left side when in bed trying to sleep... four nights so far

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: Left hip pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Survey response — day 7, dose 1
MedDRA: Arthralgia — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: Pain in hip area when laying down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-18
Dose 2 — Pfizer-BioNTech
2021-01-18
Survey response — day 0, dose 2
MedDRA: Limb discomfort — Feeling: Fair · Site: Pain · Nausea

Free text: Sore arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Nausea

Free text: The hip area pain came back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Joint pains

Free text: Lower left side again like it was on the 1st shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: Same pain in left hip area as the first time I got my first shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Vaccine positive rechallenge — Feeling: Fair · Muscle or body aches

Free text: Left hip pain like when I had the 1st shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Fair · Site: Pain · Joint pains

Free text: Joint pain like is was on my first shot.. if it means anything

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — day 7, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Muscle or body aches

Free text: Left lower hip like I got on my 1st shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-15
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-02-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-04-19
Survey response — 3 months, dose 2
MedDRA: Pain in extremity — Feeling: Fair

Free text: Leg pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-20
Survey response — 6 months, dose 2
MedDRA: Peripheral arterial occlusive disease, Thrombosis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Blockage of left leg.. I have pad.. but I dont think its due to vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-07-20
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-02
Call 1 — Left Voicemail
2022-01-18
Survey response — 12 months, dose 2
MedDRA: Poor peripheral circulation, Pre-existing disease, Toe amputation — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Lack of blood to foot.. have PAD LOST all my toes

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Dose 3 — Pfizer-BioNTech
2022-04-20
Survey response — day 0, dose 3
MedDRA: No adverse event — Feeling: Fair

Free text: Good

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Survey response — days 1–6 daily, dose 3
MedDRA: No adverse event — Feeling: Good

Free text: All good

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-28	Pfizer-BioNTech
2	2021-01-18	Pfizer-BioNTech
3	2022-04-20	Pfizer-BioNTech	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 1 — day 0, dose 1

2020-12-28

Systemic reaction (other): Sore arm

Release 1 — days 1–6 daily, dose 1

2020-12-30

Systemic reaction (other): My muscle at left hip hurts

2020-12-31

Systemic reaction (other): Left hip mussel pain

2021-01-01

Systemic reaction (other): Muscle aches lower left side when in bed trying to sleep... four nights so far

2021-01-03

Systemic reaction (other): Left hip pain

Release 1 — day 7, dose 1

2021-01-04

Systemic reaction (other): Pain in hip area when laying down

Release 2 — day 0, dose 2

2021-01-18

Systemic reaction (other): Sore arm

Release 2 — days 1–6 daily, dose 2

2021-01-19

Systemic reaction (other): The hip area pain came back

2021-01-21

Systemic reaction (other): Lower left side again like it was on the 1st shot

2021-01-22

Systemic reaction (other): Same pain in left hip area as the first time I got my first shot

2021-01-23

Systemic reaction (other): Left hip pain like when I had the 1st shot

2021-01-24

Systemic reaction (other): Joint pain like is was on my first shot.. if it means anything

Release 2 — day 7, dose 2

2021-01-25

Systemic reaction (other): Left lower hip like I got on my 1st shot

Release 7 — 3 months, dose 2

2021-04-19

Symptoms: Leg pain

Release 9 — 6 months, dose 2

2021-07-20

Symptoms: Blockage of left leg.. I have pad.. but I dont think its due to vaccine

Release 10 — 12 months, dose 2

2022-01-18

Symptoms: Lack of blood to foot.. have PAD LOST all my toes

Release 11 — day 0, dose 3

2022-04-20

Systemic reaction (other): Good

Release 11 — days 1–6 daily, dose 3

2022-04-21

Systemic reaction (other): All good

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	Pain in extremity	✓	✓	✓
SD	Peripheral arterial occlusive disease	·	·	✓
SD	Poor peripheral circulation	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Thrombosis	·	·	✓
SD	Toe amputation	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Flank pain	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Vaccine positive rechallenge	✓	✓	✓

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