XUG-10806-99605

2 vaccinations 13 coded responses 17 check-ins 13 free-text entries 12 call cases

Sex: Male
Age at first dose: 36-40
ZIP prefix: 070 / NJ
Registered: 2021-05-28

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

2021-05-26
Dose 1 — Pfizer-BioNTech
2021-05-28
Registered in v-safe
2021-05-28
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Medical counselling, Sensory disturbance — Feeling: Fair · Site: Pain, Redness, Swelling · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-28
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-02
Survey response — 7 day, dose 1
MedDRA: Paraesthesia — Feeling: Fair · Site: Pain · Muscle or body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-10
Health check-in — 14 day, dose 1
Feeling: Fair

Adult check-in
2021-06-16
Dose 2 — Pfizer-BioNTech
2021-06-16
Survey response — 0 day, dose 2
MedDRA: Hypoaesthesia, Medical counselling, Paraesthesia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-16
Report sent to call center — 0 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-17
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling, Muscular weakness, Paraesthesia — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-17
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-18
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain, Office visit — Feeling: Fair · Site: Pain · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-18
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-18
Call 1 — Left Voicemail
2021-06-19
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit, Shoulder injury related to vaccine administration — Feeling: Good · Site: Pain · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-19
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-20
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit, Shoulder injury related to vaccine administration — Feeling: Good · Site: Pain · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-20
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-21
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit, Shoulder injury related to vaccine administration — Feeling: Good · Site: Pain · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-21
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit, Shoulder injury related to vaccine administration — Feeling: Good · Site: Pain · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-22
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-23
Survey response — 7 day, dose 2
MedDRA: Office visit, Shoulder injury related to vaccine administration — Feeling: Good · Site: Pain · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-23
Report sent to call center — 7 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-24
Call 1 — Left Voicemail
2021-06-30
Survey response — 14 day, dose 2
MedDRA: Office visit, Shoulder injury related to vaccine administration — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-30
Report sent to call center — 14 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-07
Health check-in — 21 day, dose 2
Feeling: Fair

Adult check-in
2021-07-14
Health check-in — 28 day, dose 2
Feeling: Fair

Adult check-in
2021-07-21
Survey response — 35 day, dose 2
MedDRA: Office visit, Shoulder injury related to vaccine administration — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2021-07-21
Report sent to call center — 35 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-27
Call 1 — Left Voicemail
2021-07-28
Survey response — 42 day, dose 2
MedDRA: Office visit, Shoulder injury related to vaccine administration — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-07-28
Report sent to call center — 42 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-09
Call 1 — Left Voicemail
2021-09-15
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-26	Pfizer-BioNTech
2	2021-06-16	Pfizer-BioNTech

Call center

Reported	Outcome	VAERS-related outcome
2021-05-28	Unsuccessful
2021-06-16	Unsuccessful
2021-06-17	Unsuccessful
2021-06-18	Unsuccessful
2021-06-19	Unsuccessful
2021-06-20	Unsuccessful
2021-06-21	Unsuccessful
2021-06-22	Unsuccessful
2021-06-23	Unsuccessful
2021-06-30	Unsuccessful
2021-07-21	Unsuccessful
2021-07-28	Unsuccessful

Free text

Release 8

Systemic reaction (other): Injection arm hand numbness/strange sensation

Healthcare visit (other): Phone consultation

Systemic reaction (other): Right arm tingling

Release 9

Systemic reaction (other): Tingling/numbness in opposite arm (right) which received first covid vaccine

Healthcare visit (other): Phone conversation

Systemic reaction (other): Right arm shot #1 weakness and tingling

Healthcare visit (other): Phone call

Systemic reaction (other): Right arm first shot injection. Likely administered incorrectly and hit bursa

Healthcare visit (other): Dr office visit

Systemic reaction (other): Right arm first injection SIRVA

Healthcare visit (other): Dr office visit

Systemic reaction (other): Right arm first shot injections SIRVA

Healthcare visit (other): Doctor office visit

Systemic reaction (other): Right arm injection #1 SIRVA

Healthcare visit (other): Office visit

Systemic reaction (other): Right arm shot #1 SIRVA

Healthcare visit (other): Doctor office visit

Systemic reaction (other): Right arm first shot SIRVA

Healthcare visit (other): Dr office visit

Symptoms: Right arm injection #1 SIRVA

Healthcare visit (other): Dr Office Visit

Symptoms: Right arm injection #1 SIRVA

Healthcare visit (other): Dr. Office Visit

Symptoms: SIRVA injury injection #1

Healthcare visit (other): Dr. Office visit

Free-text releases are not linked to a specific 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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Shoulder injury related to vaccine administration	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Sensory disturbance	✓	✓	✓
SRO	Shoulder injury related to vaccine administration	✓	✓	✓

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