2X9-13730-91297
3 vaccinations
4 coded responses
29 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 603 / IL
- Registered
- 2021-12-07
- Relationship
- Child or adolescent in my care
- Guardian
- KCL-13183-04135
- Race
- N/A
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-12-07
Registered in v-safe
-
2021-12-07
Dose 1 — Pfizer-BioNTech
- 2021-12-07
- 2021-12-09
-
2021-12-10
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Agitation — Feeling: GoodFree text: AgitationMedDRA releases: 2024-11 · check-in free text available
- 2021-12-11
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-21
-
2021-12-28
Dose 2 — Pfizer-BioNTech
-
2021-12-30
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
-
2021-12-31
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Poor · Fever · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-01-01
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Fever · None · Be unable to work or attend schoolAdult check-in
- 2022-01-04
-
2022-01-11
Survey response — day 14, dose 2, dependentMedDRA: COVID-19 — Feeling: Good · Be unable to work or attend schoolFree text: CovidMedDRA releases: 2024-11 · check-in free text available
- 2022-01-18
- 2022-01-25
- 2022-02-01
- 2022-02-08
- 2022-03-29
- 2022-06-30
-
2022-07-12
Dose 3 — Pfizer-BioNTech
- 2022-07-17
- 2022-07-18
-
2022-07-19
Survey response — day 7, dose 3, dependentMedDRA: Cough — Feeling: GoodFree text: CoughMedDRA releases: 2024-11 · check-in free text available
-
2022-07-26
Survey response — day 14, dose 3, dependentMedDRA: Cough — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: worsening coughMedDRA releases: 2024-11 · check-in free text available
- 2022-08-04
- 2022-08-09
- 2022-08-16
- 2022-08-23
- 2022-10-11
- 2023-01-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-12-07 | Pfizer-BioNTech | No |
| 2 | 2021-12-28 | Pfizer-BioNTech | No |
| 3 | 2022-07-12 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Agitation
Release 10 — day 14, dose 2, dependent
Symptoms: Covid
Release 12 — day 7, dose 3, dependent
Systemic reaction (other): Cough
Release 12 — day 14, dose 3, dependent
Symptoms: worsening cough
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 | COVID-19 | · | · | ✓ |
| SRO | Agitation | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release