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29V-10666-78092

2 vaccinations 5 coded responses 11 check-ins 5 free-text entries 2 call cases
Sex
Male
Age at first dose
12-15
ZIP prefix
125 / NY
Registered
2021-09-03
Relationship
Child or adolescent in my care
Guardian
3KU-32084-14469
Race
White
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-08-13
    Dose 1 — Pfizer-BioNTech
  2. 2021-09-03
    Registered in v-safe
  3. 2021-09-03
    Dose 2 — Pfizer-BioNTech
  4. 2021-09-04
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness
    Adult check-in
  5. 2021-09-06
    Survey response — days 1–6 daily, dose 2, dependent
    MedDRA: Neck mass — Feeling: Fair
    Free text: Lump on left side of neck
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  6. 2021-09-07
    Survey response — days 1–6 daily, dose 2, dependent
    MedDRA: Sensation of foreign body — Feeling: Fair
    Free text: Lump in left side of throat
    MedDRA releases: 2024-11 · check-in free text available
  7. 2021-09-10
    Survey response — day 7, dose 2, dependent
    MedDRA: Lymphadenopathy — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Swollen Lymph nodes
    MedDRA releases: 2024-11 · check-in free text available
  8. 2021-09-10
    Report sent to call center — day 7, dose 2, dependent
    Get care from a doctor or other healthcare professional
    1 call case(s)
  9. 2021-09-15
  10. 2021-09-19
    Health check-in — day 14, dose 2, dependent
    Feeling: Good
    Adult check-in
  11. 2021-09-26
    Health check-in — day 21, dose 2, dependent
    Feeling: Fair
    Adult check-in
  12. 2021-10-03
    Health check-in — day 28, dose 2, dependent
    Feeling: Good
    Adult check-in
  13. 2021-10-08
    Health check-in — day 35, dose 2, dependent
    Feeling: Good
    Adult check-in
  14. 2021-10-16
    Health check-in — day 42, dose 2, dependent
    Feeling: Good
    Adult check-in
  15. 2021-12-05
    Survey response — 3 months, dose 2, dependent
    MedDRA: Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school
    Free text: Upper respiratory infection
    MedDRA releases: 2024-11 · check-in free text available
  16. 2022-09-03
    Survey response — 12 months, dose 2, dependent
    MedDRA: Chest pain, Palpitations — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    Free text: Chest pain, palpitations
    MedDRA releases: 2024-11 · check-in free text available
  17. 2022-09-03
    Report sent to call center — 12 months, dose 2, dependent
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  18. 2022-09-06
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  19. 2022-09-06
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-08-13Pfizer-BioNTech No
22021-09-03Pfizer-BioNTech No

Call center

ReportedOutcomeVAERS-related outcome
2021-09-10 Successful
2022-09-06
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-03 Successful
2022-09-06
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 9 — days 1–6 daily, dose 2, dependent

2021-09-06

Systemic reaction (other): Lump on left side of neck

2021-09-07

Systemic reaction (other): Lump in left side of throat

Release 9 — day 7, dose 2, dependent

2021-09-10

Systemic reaction (other): Swollen Lymph nodes

Release 10 — 3 months, dose 2, dependent

2021-12-05

Symptoms: Upper respiratory infection

Release 12 — 12 months, dose 2, dependent

2022-09-03

Symptoms: Chest pain, palpitations

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
SDChest pain · · ✓
SDPalpitations · · ✓
SDUpper respiratory tract infection · · ✓
SROLymphadenopathy · · ✓
SRONeck mass ✓ · ✓
SROSensation of foreign body · · ✓

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