3QS-28901-95475
2 vaccinations
3 coded responses
15 check-ins
2 free-text entries
2 call cases
- Sex
- —
- Age at first dose
- 0-4
- ZIP prefix
- 182 / PA
- Registered
- 2022-09-16
- Relationship
- Child or adolescent in my care
- Guardian
- 2G2-33468-42961
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-09-16
Registered in v-safe
-
2022-09-16
Dose 1 — Pfizer-BioNTechCo-administered: Flu
- 2022-09-16
- 2022-09-17
- 2022-09-18
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-22
- 2022-09-23
- 2022-09-30
-
2022-10-07
Dose 2 — Pfizer-BioNTech
- 2022-10-14
- 2022-10-24
-
2022-10-30
Survey response — day 21, dose 2, dependentMedDRA: Abdominal pain upper, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Stomach pain · Healthcare visit (other): Annual GP visit. Requested we do an ultrasound and bloodworkMedDRA releases: 2024-11 · check-in free text available
-
2022-10-30
Report sent to call center — day 21, dose 2, dependentGet care from a doctor or other healthcare professional1 call case(s)
-
2022-10-31
Call successfulDoes not wish to fill out VAERS report
-
2022-11-11
Survey response — day 35, dose 2, dependentMedDRA: Blood bilirubin increased, Blood glucose increased, Blood test abnormal, Gastrointestinal disorder, Nasal congestion, Nasopharyngitis, Pre-existing disease — Feeling: FairFree text: Still has stomach issues. Ultrasound normal. Blood work showed elevated blood sugar and bilirubin but not sure cause. Think his GP sending us to gastro next. Just has a stuffy nose today which may be a cold or allergy.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-21
-
2023-04-09
Survey response — 6 months, dose 2, dependentMedDRA: Autism spectrum disorder, Failure to thrive, Gastrointestinal tube insertion, Gender dysphoria, Malnutrition, Selective eating disorder — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
-
2023-04-09
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 prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2023-04-10
- 2023-04-13
- 2023-04-17
-
2023-04-19
Callback requested for01:00PM ET
- 2023-04-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-09-16 | Pfizer-BioNTech | Flu |
| 2 | 2022-10-07 | Pfizer-BioNTech | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 12 — day 21, dose 2, dependent
Symptoms: Stomach pain
Healthcare visit (other): Annual GP visit. Requested we do an ultrasound and bloodwork
Release 12 — day 35, dose 2, dependent
Symptoms: Still has stomach issues. Ultrasound normal. Blood work showed elevated blood sugar and bilirubin but not sure cause. Think his GP sending us to gastro next. Just has a stuffy nose today which may be a cold or allergy.
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 | · | · | ✓ |
| SD | Abdominal pain upper | · | · | ✓ |
| SD | Autism spectrum disorder | · | · | ✓ |
| SD | Blood bilirubin increased | · | · | ✓ |
| SD | Blood glucose increased | · | · | ✓ |
| SD | Blood test abnormal | · | · | ✓ |
| SD | Failure to thrive | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Gastrointestinal tube insertion | · | · | ✓ |
| SD | Gender dysphoria | · | · | ✓ |
| SD | Malnutrition | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Selective eating disorder | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release