39L-65363-98797
2 vaccinations
4 coded responses
15 check-ins
4 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 12-15
- ZIP prefix
- 981 / WA
- Registered
- 2021-06-03
- Relationship
- Self
- Race
- N/A
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-05-13
Dose 1 — Pfizer-BioNTech
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2021-06-03
Registered in v-safe
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2021-06-03
Dose 2 — Pfizer-BioNTech
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2021-06-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-06-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-06-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessAdult check-in
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2021-06-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessAdult check-in
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2021-06-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessAdult check-in
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2021-06-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessAdult check-in
- 2021-06-10
- 2021-06-17
- 2021-06-24
- 2021-07-01
- 2021-07-08
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2021-07-15
Survey response — day 42, dose 2MedDRA: Body temperature increased, Fatigue, Nasal congestion, Nasopharyngitis, Sneezing — Feeling: FairFree text: Caught a summer cold. Whole family caught it. Adult Family members got tested & were negative for COVID, so we know it is a typical cold. Clogged nose, sneezing, small elevated temperature, overall tired. Took a nap, felt better.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-09-02
Survey response — 3 months, dose 2MedDRA: Ear infection, Pyrexia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Double outer ear infections. Not COVID related but have fevers due to the ear infections.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-09-02
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-09-09
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2021-12-02
Survey response — 6 months, dose 2MedDRA: Ear infection, Peripheral swelling, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Swollen Leg from where the hardware is located due to the tumor in the bone Ear Infection again (non-COVID related)MedDRA releases: 2024-11 · check-in free text available
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2021-12-02
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2021-12-06
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-06-04
Survey response — 12 months, dose 2MedDRA: Nasopharyngitis — Feeling: GoodFree text: Had a typical cold. Took rapid tests every other day & had a PCR on day 7. All came back negative.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-13 | Pfizer-BioNTech | |
| 2 | 2021-06-03 | Pfizer-BioNTech |
Call center
2 call center cases
2 successful
Free text
Release 9 — day 42, dose 2
Symptoms: Caught a summer cold. Whole family caught it. Adult Family members got tested & were negative for COVID, so we know it is a typical cold. Clogged nose, sneezing, small elevated temperature, overall tired. Took a nap, felt better.
Release 9 — 3 months, dose 2
Symptoms: Double outer ear infections. Not COVID related but have fevers due to the ear infections.
Release 10 — 6 months, dose 2
Symptoms: Swollen Leg from where the hardware is located due to the tumor in the bone Ear Infection again (non-COVID related)
Release 11 — 12 months, dose 2
Symptoms: Had a typical cold. Took rapid tests every other day & had a PCR on day 7. All came back negative.
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 | Body temperature increased | ✓ | · | ✓ |
| SD | Ear infection | ✓ | · | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Nasal congestion | ✓ | · | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | Peripheral swelling | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | ✓ | · | ✓ |
| SD | Sneezing | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release