3QV-35007-30237
2 vaccinations
3 coded responses
13 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 900 / CA
- Registered
- 2021-12-14
- Relationship
- Child or adolescent in my care
- Guardian
- LWS-56957-53981
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-11-22
Dose 1 — Pfizer-BioNTech
-
2021-12-13
Dose 2 — Pfizer-BioNTech
-
2021-12-14
Registered in v-safe
-
2021-12-14
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
-
2021-12-16
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Fatigue — Feeling: GoodFree text: We missed (b)(6) health check-in yesterday, yesterday he felt tired. Today he feels fine.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-18
- 2021-12-19
-
2021-12-21
Survey response — day 7, dose 2, dependentMedDRA: Body temperature increased — Feeling: GoodFree text: He had a slight fever yesterday, 99.4, we didn't get a chance to report on v-safe. Today he's fine.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-27
- 2022-01-03
- 2022-01-10
- 2022-01-17
- 2022-01-26
- 2022-03-14
- 2022-06-13
-
2022-12-13
Survey response — 12 months, dose 2, dependentMedDRA: Cough, Pyrexia, Rhinorrhoea, Vomiting — Feeling: Good · Be unable to work or attend schoolFree text: Vomiting, runny nose, coughing, feverMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-22 | Pfizer-BioNTech | No |
| 2 | 2021-12-13 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): We missed (b)(6) health check-in yesterday, yesterday he felt tired. Today he feels fine.
redacted (b)(6)
Release 10 — day 7, dose 2, dependent
Systemic reaction (other): He had a slight fever yesterday, 99.4, we didn't get a chance to report on v-safe. Today he's fine.
Release 12 — 12 months, dose 2, dependent
Symptoms: Vomiting, runny nose, coughing, fever
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 | Cough | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Body temperature increased | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release