3FA-17207-96283
2 vaccinations
3 coded responses
7 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 121 / NY
- Registered
- 2022-02-06
- Relationship
- Child or adolescent in my care
- Guardian
- 94V-57141-76335
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-12-21
Dose 1 — Pfizer-BioNTech
-
2022-01-11
Dose 2 — Pfizer-BioNTech
-
2022-02-06
Registered in v-safe
- 2022-02-06
- 2022-02-08
-
2022-02-15
Survey response — day 35, dose 2, dependentMedDRA: Headache — Feeling: GoodFree text: HeadacheMedDRA releases: 2024-11 · check-in free text available
- 2022-02-22
-
2022-04-12
Survey response — 3 months, dose 2, dependentMedDRA: Cough, Rhinorrhoea — Feeling: Fair · Be unable to work or attend schoolFree text: Cough, snifflesMedDRA releases: 2024-11 · check-in free text available
-
2022-07-12
Survey response — 6 months, dose 2, dependentMedDRA: Abdominal pain upper, Constipation, Pyrexia — Feeling: Poor · Be unable to work or attend school, 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: Stomach pain, fever, constipationMedDRA releases: 2024-11 · check-in free text available
-
2022-07-12
Report sent to call center — 6 months, dose 2, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-07-13
-
2022-07-13
Call successfulNot applicable - Accidental Reporting
- 2023-01-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-12-21 | Pfizer-BioNTech | No |
| 2 | 2022-01-11 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 11 — day 35, dose 2, dependent
Symptoms: Headache
Release 11 — 3 months, dose 2, dependent
Symptoms: Cough, sniffles
Release 12 — 6 months, dose 2, dependent
Symptoms: Stomach pain, fever, constipation
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 | Abdominal pain upper | · | · | ✓ |
| SD | Constipation | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release