423-10430-55853
2 vaccinations
2 coded responses
23 check-ins
2 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 12-15
- ZIP prefix
- 372 / TN
- Registered
- 2021-07-17
- Relationship
- Child or adolescent in my care
- Guardian
- SQH-22156-94767
- Race
- Multiracial
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-07-17
Registered in v-safe
-
2021-07-17
Dose 1 — Pfizer-BioNTech
- 2021-07-17
-
2021-07-18
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-07-19
- 2021-07-20
- 2021-07-21
- 2021-07-22
- 2021-07-24
- 2021-08-02
-
2021-08-07
Dose 2 — Pfizer-BioNTech
-
2021-08-07
Survey response — day 0, dose 2, dependentMedDRA: Arthralgia, Back pain — Feeling: Fair · Site: PainFree text: Odd pain on left side back, and left shoulder painMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-08
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-08-09
- 2021-08-10
- 2021-08-11
- 2021-08-12
- 2021-08-13
- 2021-08-14
- 2021-08-21
- 2021-08-29
- 2021-09-04
- 2021-09-11
- 2021-09-18
- 2021-11-08
-
2022-02-05
Survey response — 6 months, dose 2, dependentMedDRA: COVID-19, Hypersensitivity, Pre-existing disease — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Severe allergies sensitivity and caught covidMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-07-17 | Pfizer-BioNTech | No |
| 2 | 2021-08-07 | Pfizer-BioNTech | No |
Free text
Release 9 — day 0, dose 2, dependent
Systemic reaction (other): Odd pain on left side back, and left shoulder pain
Release 11 — 6 months, dose 2, dependent
Symptoms: Severe allergies sensitivity and caught covid
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 | COVID-19 | · | · | ✓ |
| SD | Hypersensitivity | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Arthralgia | ✓ | · | ✓ |
| SRO | Back pain | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release