2QW-91794-92964
3 vaccinations
7 coded responses
26 check-ins
6 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 919 / CA
- Registered
- 2022-01-28
- Relationship
- Child or adolescent in my care
- Guardian
- NM3-39749-74187
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-01-28
Registered in v-safe
-
2022-01-28
Dose 1 — Pfizer-BioNTech
-
2022-01-28
Survey response — day 0, dose 1, dependentMedDRA: Pre-existing disease — Feeling: GoodFree text: Medical history of peanut/tree nut allergies with anaphylaxis, no symptoms after injectionMedDRA releases: 2024-11 · check-in free text available
- 2022-01-29
- 2022-01-30
- 2022-01-31
-
2022-02-02
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend schoolFree text: Parents tested positive for Covid yesterday with mild congestion, kids showing no symptomsMedDRA releases: 2024-11 · check-in free text available
-
2022-02-04
Survey response — day 7, dose 1, dependentMedDRA: Unevaluable event — Feeling: Good · Be unable to work or attend schoolFree text: Parents tested positive a few days ago with mild congestion, child tested negative yesterday with no symptomsMedDRA releases: 2024-11 · check-in free text available
- 2022-02-12
-
2022-02-19
Dose 2 — Pfizer-BioNTech
- 2022-02-19
- 2022-02-20
- 2022-02-21
- 2022-02-23
- 2022-02-25
- 2022-02-26
- 2022-03-13
- 2022-03-20
- 2022-03-26
- 2022-04-04
-
2022-08-02
Dose 3 — Pfizer-BioNTechCo-administered: HPV
-
2022-08-04
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Ear pain — Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activitiesFree text: Ear pain like a middle ear infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-08-05
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Ear pain — Feeling: Fair · Headache, Fatigue or tirednessFree text: Ear still hurts (similar to middle ear infection pain)MedDRA releases: 2024-11 · check-in free text available
-
2022-08-07
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Ear pain — Feeling: GoodFree text: Ear still hurting mildly but has gotten betterMedDRA releases: 2024-11 · check-in free text available
- 2022-08-09
- 2022-08-23
- 2022-08-30
- 2022-09-13
- 2022-11-03
-
2023-02-03
Survey response — 6 months, dose 3, dependentMedDRA: Cough, Epistaxis, Rhinorrhoea — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-01-28 | Pfizer-BioNTech | No |
| 2 | 2022-02-19 | Pfizer-BioNTech | No |
| 3 | 2022-08-02 | Pfizer-BioNTech | HPV |
Free text
Release 11 — day 0, dose 1, dependent
Systemic reaction (other): Medical history of peanut/tree nut allergies with anaphylaxis, no symptoms after injection
Release 11 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Parents tested positive for Covid yesterday with mild congestion, kids showing no symptoms
Release 11 — day 7, dose 1, dependent
Systemic reaction (other): Parents tested positive a few days ago with mild congestion, child tested negative yesterday with no symptoms
Release 12 — days 1–6 daily, dose 3, dependent
Systemic reaction (other): Ear pain like a middle ear infection
Systemic reaction (other): Ear still hurts (similar to middle ear infection pain)
Systemic reaction (other): Ear still hurting mildly but has gotten better
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 | Cough | · | · | ✓ |
| SD | Epistaxis | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Ear pain | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
| SRO | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release