2LH-22975-34849

3 vaccinations 11 coded responses 35 check-ins 8 free-text entries 3 call cases

Sex: Male
Age at first dose: 05-11
ZIP prefix: 028 / RI
Registered: 2021-11-17

Relationship: Child or adolescent in my care
Guardian: 64M-31484-16481
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-11-17
Registered in v-safe
2021-11-17
Dose 1 — Pfizer-BioNTech
2021-11-17
Survey response — day 0, dose 1, dependent
MedDRA: No adverse event — Feeling: Fair · Site: Pain · Headache, Joint pains

Free text: Injection didn't hurt!

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-23
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-24
Health check-in — day 7, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-12-01
Health check-in — day 14, dose 1, dependent
Feeling: Good

Adult check-in
2021-12-08
Dose 2 — Pfizer-BioNTech
2021-12-08
Survey response — day 0, dose 2, dependent
MedDRA: No adverse event — Feeling: Good · Site: Pain · Headache

Free text: None

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-10
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Axillary pain — Feeling: Good

Free text: Sore armpit in arm from vax noticed am 48hrs postvax

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Axillary pain — Feeling: Good

Free text: Still some sore am under armpit vax arm

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-13
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Headache

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-15
Health check-in — day 7, dose 2, dependent
Feeling: Good · Headache

Adult check-in
2021-12-22
Health check-in — day 14, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-29
Health check-in — day 21, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-05
Health check-in — day 28, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-12
Health check-in — day 35, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-19
Health check-in — day 42, dose 2, dependent
Feeling: Good

Adult check-in
2022-03-09
Survey response — 3 months, dose 2, dependent
MedDRA: Lymphadenopathy, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Slight lump under right chest/breast same side as vax and lymph node armpit swelling following vax · Healthcare visit (other): Pediatrician checkup

MedDRA releases: 2024-11 · check-in free text available
2022-03-09
Report sent to call center — 3 months, dose 2, dependent
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-11
Call 1 — Left Voicemail
2022-06-08
Survey response — 6 months, dose 2, dependent
MedDRA: Breast mass, Office visit, Respiratory tract congestion, Unevaluable event — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional

Free text: Symptoms: Had temp and congestion few dys in earlyMay...slight mammory growth one side · Healthcare visit (other): Asked about gorwth during annual inperson physixal said ealry but not uncommon prepubescent

MedDRA releases: 2024-11 · check-in free text available
2022-06-08
Report sent to call center — 6 months, dose 2, dependent
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-22
Dose 3 — Pfizer-BioNTech
2022-11-22
Survey response — day 0, dose 3, dependent
MedDRA: Emotional disorder — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: Highly emotional...FYI this is his 3rd shot

MedDRA releases: 2024-11 · check-in free text available
2022-11-25
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-11-26
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-11-27
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-11-29
Health check-in — day 7, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-12-07
Survey response — day 14, dose 3, dependent
MedDRA: Cough, Head injury, Headache, Nasal congestion, Pyrexia — 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

Free text: Fever cough nasal congestion headache plus head injury hockey game

MedDRA releases: 2024-11 · check-in free text available
2022-12-07
Report sent to call center — day 14, dose 3, 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 · 1 call case(s)
2022-12-07
Call 1 — Left Voicemail
2022-12-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-13
Health check-in — day 21, dose 3, dependent
Feeling: Good

Adult check-in
2022-12-20
Health check-in — day 28, dose 3, dependent
Feeling: Good

Adult check-in
2022-12-27
Health check-in — day 35, dose 3, dependent
Feeling: Good

Adult check-in
2023-01-03
Survey response — day 42, dose 3, dependent
MedDRA: Headache, Oropharyngeal pain, Pyrexia, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-02-22
Survey response — 3 months, dose 3, dependent
MedDRA: Gastroenteritis viral, Pyrexia, Upper respiratory tract infection — Feeling: Good · Be unable to work or attend school

MedDRA releases: 2024-11
2023-05-23
Survey response — 6 months, dose 3, dependent
MedDRA: Amenorrhoea, Hot flush, Menstruation irregular — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-11-17	Pfizer-BioNTech	No
2	2021-12-08	Pfizer-BioNTech	No
3	2022-11-22	Pfizer-BioNTech	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 10 — day 0, dose 1, dependent

2021-11-17

Systemic reaction (other): Injection didn't hurt!

Release 10 — day 0, dose 2, dependent

2021-12-08

Systemic reaction (other): None

Release 10 — days 1–6 daily, dose 2, dependent

2021-12-10

Systemic reaction (other): Sore armpit in arm from vax noticed am 48hrs postvax

2021-12-11

Systemic reaction (other): Still some sore am under armpit vax arm

Release 11 — 3 months, dose 2, dependent

2022-03-09

Symptoms: Slight lump under right chest/breast same side as vax and lymph node armpit swelling following vax

Healthcare visit (other): Pediatrician checkup

Release 11 — 6 months, dose 2, dependent

2022-06-08

Symptoms: Had temp and congestion few dys in earlyMay...slight mammory growth one side

Healthcare visit (other): Asked about gorwth during annual inperson physixal said ealry but not uncommon prepubescent

Release 12 — day 0, dose 3, dependent

2022-11-22

Systemic reaction (other): Highly emotional...FYI this is his 3rd shot

Release 12 — day 14, dose 3, dependent

2022-12-07

Symptoms: Fever cough nasal congestion headache plus head injury hockey game

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
HCVO	Office visit	·	·	✓
SD	Amenorrhoea	·	·	✓
SD	Breast mass	·	·	✓
SD	Cough	·	·	✓
SD	Gastroenteritis viral	·	·	✓
SD	Head injury	·	·	✓
SD	Headache	·	·	✓
SD	Hot flush	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Menstruation irregular	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Emotional disorder	·	·	✓
SRO	No adverse event	·	·	✓

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