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
-
2021-08-13
Dose 1 — Pfizer-BioNTech
-
2021-09-03
Registered in v-safe
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2021-09-03
Dose 2 — Pfizer-BioNTech
-
2021-09-04
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
-
2021-09-06
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Neck mass — Feeling: FairFree text: Lump on left side of neckMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-07
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Sensation of foreign body — Feeling: FairFree text: Lump in left side of throatMedDRA releases: 2024-11 · check-in free text available
-
2021-09-10
Survey response — day 7, dose 2, dependentMedDRA: Lymphadenopathy — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Swollen Lymph nodesMedDRA releases: 2024-11 · check-in free text available
-
2021-09-10
Report sent to call center — day 7, dose 2, dependentGet care from a doctor or other healthcare professional1 call case(s)
- 2021-09-15
- 2021-09-19
- 2021-09-26
- 2021-10-03
- 2021-10-08
- 2021-10-16
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2021-12-05
Survey response — 3 months, dose 2, dependentMedDRA: Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend schoolFree text: Upper respiratory infectionMedDRA releases: 2024-11 · check-in free text available
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2022-09-03
Survey response — 12 months, dose 2, dependentMedDRA: 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 visitFree text: Chest pain, palpitationsMedDRA releases: 2024-11 · check-in free text available
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2022-09-03
Report sent to call center — 12 months, dose 2, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-09-06
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-09-06
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-13 | Pfizer-BioNTech | No |
| 2 | 2021-09-03 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-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
Systemic reaction (other): Lump on left side of neck
Systemic reaction (other): Lump in left side of throat
Release 9 — day 7, dose 2, dependent
Systemic reaction (other): Swollen Lymph nodes
Release 10 — 3 months, dose 2, dependent
Symptoms: Upper respiratory infection
Release 12 — 12 months, dose 2, dependent
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Chest pain | · | · | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Neck mass | ✓ | · | ✓ |
| SRO | Sensation of foreign body | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release