28Y-21923-91789
3 vaccinations
5 coded responses
21 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 194 / PA
- Registered
- 2021-11-08
- Relationship
- Child or adolescent in my care
- Guardian
- BSZ-18284-12456
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-04
Dose 1 — Pfizer-BioNTech
-
2021-11-08
Registered in v-safe
- 2021-11-08
- 2021-11-09
- 2021-11-11
- 2021-11-18
- 2021-11-25
-
2021-11-26
Dose 2 — Pfizer-BioNTech
- 2021-11-29
-
2021-11-30
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Abdominal pain, Constipation, Ocular hyperaemia, Pre-existing disease — Feeling: GoodFree text: Bloodshot eyes (but I think it's because of longer mask wearing,) has been complaining of belly ache (likely constipation which has always been an issue for him)MedDRA releases: 2024-11 · check-in free text available
- 2021-12-01
- 2021-12-04
- 2021-12-12
-
2021-12-17
Survey response — day 21, dose 2, dependentMedDRA: Loss of personal independence in daily activities, Vomiting — Feeling: Good · Be unable to work or attend schoolFree text: Missed one day of school for vomiting. Threw up two times. Resumed eating within hour of vomit and kept food/water downMedDRA releases: 2024-11 · check-in free text available
-
2021-12-26
Survey response — day 28, dose 2, dependentMedDRA: Cough, Loss of personal independence in daily activities, Nasal congestion, SARS-CoV-2 test negative, Vomiting — Feeling: Good · Be unable to work or attend schoolFree text: Cough (minor,) stuffy nose Vomiting two times on one morning last week - short lived and he was eating hour later. Stayed home from school. Negative Covid rapid testMedDRA releases: 2024-11 · check-in free text available
- 2022-01-09
- 2022-02-25
-
2022-05-21
Dose 3 — Pfizer-BioNTech
-
2022-05-23
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Poor · Site: Pain · Headache, Nausea, Vomiting · Be unable to work or attend schoolAdult check-in
-
2022-05-24
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Fatigue, Headache, Nausea, Pyrexia, Vomiting — Feeling: GoodFree text: Because of when I entered his vaccine into app, I wasn't asked about day 1 and 2. During those days, he experienced fever, nausea, tiredness, vomiting, and headache. (b)(6) is doing well today.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-25
- 2022-06-23
- 2022-06-25
- 2022-07-02
-
2022-08-20
Survey response — 3 months, dose 3, dependentMedDRA: Abdominal pain, Hypersomnia, Malaise, Productive cough, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activitiesFree text: Had high fever. Tummy ache, but only spit up once. Slept a lot. Sick over couple days. 2 negative Covid tests.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-04 | Pfizer-BioNTech | No |
| 2 | 2021-11-26 | Pfizer-BioNTech | No |
| 3 | 2022-05-21 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Bloodshot eyes (but I think it's because of longer mask wearing,) has been complaining of belly ache (likely constipation which has always been an issue for him)
Release 10 — day 21, dose 2, dependent
Symptoms: Missed one day of school for vomiting. Threw up two times. Resumed eating within hour of vomit and kept food/water down
Release 10 — day 28, dose 2, dependent
Symptoms: Cough (minor,) stuffy nose Vomiting two times on one morning last week - short lived and he was eating hour later. Stayed home from school. Negative Covid rapid test
Release 11 — days 1–6 daily, dose 3, dependent
Systemic reaction (other): Because of when I entered his vaccine into app, I wasn't asked about day 1 and 2. During those days, he experienced fever, nausea, tiredness, vomiting, and headache. (b)(6) is doing well today.
redacted (b)(6)
Release 12 — 3 months, dose 3, dependent
Symptoms: Had high fever. Tummy ache, but only spit up once. Slept a lot. Sick over couple days. 2 negative Covid tests.
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 | Abdominal pain | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Hypersomnia | · | · | ✓ |
| SD | Loss of personal independence in daily activities | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Abdominal pain | · | · | ✓ |
| SRO | Constipation | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Nausea | · | · | ✓ |
| SRO | Ocular hyperaemia | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release