3MK-10238-61413
2 vaccinations
4 coded responses
10 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 05-11
- ZIP prefix
- 970 / OR
- Registered
- 2021-11-14
- Relationship
- Child or adolescent in my care
- Guardian
- 5WR-21841-24146
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-13
Dose 1 — Pfizer-BioNTech
-
2021-11-14
Registered in v-safe
-
2021-11-14
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
-
2021-11-15
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Office visit, Vision blurred — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Blurry vision · Healthcare visit (other): School nurseMedDRA releases: 2024-11 · check-in free text available
-
2021-11-15
Report sent to call center — days 1–6 daily, dose 1, dependentGet care from a doctor or other healthcare professional1 call case(s)
- 2021-11-16
-
2021-11-17
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Vision blurred — Feeling: GoodFree text: Blurry visionMedDRA releases: 2024-11 · check-in free text available
-
2021-11-19
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Office visit, Vision blurred — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Systemic reaction (other): Blurry vision · Healthcare visit (other): Blurry vision check up. Vision appointment recommendMedDRA releases: 2024-11 · check-in free text available
-
2021-11-19
Report sent to call center — days 1–6 daily, dose 1, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-20
-
2021-11-23
Call successfulParticipant prefers to complete VAERS report online
- 2021-11-29
- 2021-12-11
-
2021-12-15
Dose 2 — Pfizer-BioNTech
-
2021-12-25
Survey response — day 7, dose 2, dependentMedDRA: Pain in extremity, Vomiting — Feeling: GoodFree text: Sore arm and vomiting recently. Doing well nowMedDRA releases: 2024-11 · check-in free text available
- 2021-12-29
- 2022-01-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-13 | Pfizer-BioNTech | No |
| 2 | 2021-12-15 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 successful
Free text
Release 10 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Blurry vision
Systemic reaction (other): Blurry vision
Healthcare visit (other): Blurry vision check up. Vision appointment recommend
Release 10 — day 7, dose 2, dependent
Systemic reaction (other): Sore arm and vomiting recently. Doing well now
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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| HCVO | Vision blurred | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Vision blurred | · | · | ✓ |
| SRO | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release