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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

  1. 2021-05-13
    Dose 1 — Pfizer-BioNTech
  2. 2021-06-03
    Registered in v-safe
  3. 2021-06-03
    Dose 2 — Pfizer-BioNTech
  4. 2021-06-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  5. 2021-06-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  6. 2021-06-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness
    Adult check-in
  7. 2021-06-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness
    Adult check-in
  8. 2021-06-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness
    Adult check-in
  9. 2021-06-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness
    Adult check-in
  10. 2021-06-10
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-06-17
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-06-24
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-07-01
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-07-08
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-07-15
    Survey response — day 42, dose 2
    MedDRA: Body temperature increased, Fatigue, Nasal congestion, Nasopharyngitis, Sneezing — Feeling: Fair
    Free 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
  16. 2021-09-02
    Survey response — 3 months, dose 2
    MedDRA: 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 visit
    Free 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
  17. 2021-09-02
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  18. 2021-09-09
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  19. 2021-12-02
    Survey response — 6 months, dose 2
    MedDRA: 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 visit
    Free 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
  20. 2021-12-02
    Report sent to call center — 6 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  21. 2021-12-06
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  22. 2022-06-04
    Survey response — 12 months, dose 2
    MedDRA: Nasopharyngitis — Feeling: Good
    Free 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

DoseDateManufacturerCo-administered
12021-05-13Pfizer-BioNTech
22021-06-03Pfizer-BioNTech

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 9 — day 42, dose 2

2021-07-15

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

2021-09-02

Symptoms: Double outer ear infections. Not COVID related but have fevers due to the ear infections.

Release 10 — 6 months, dose 2

2021-12-02

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

2022-06-04

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

FieldPreferred term2021-092023-042024-11
SDBody temperature increased ✓ · ✓
SDEar infection ✓ · ✓
SDFatigue ✓ · ✓
SDNasal congestion ✓ · ✓
SDNasopharyngitis ✓ · ✓
SDPeripheral swelling · · ✓
SDPre-existing disease · · ✓
SDPyrexia ✓ · ✓
SDSneezing ✓ · ✓

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