456-42577-77056
1 vaccination
3 coded responses
12 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 927 / CA
- Registered
- 2021-11-09
- Relationship
- Child or adolescent in my care
- Guardian
- 4GN-30899-56233
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-09
Registered in v-safe
-
2021-11-09
Dose 1 — Pfizer-BioNTech
- 2021-11-09
-
2021-11-10
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection siteAdult check-in
-
2021-11-11
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-11-12
- 2021-11-13
-
2021-11-14
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Nasal congestion, Respiratory tract congestion — Feeling: GoodFree text: Mild congestion and stuffy nose, possibly due to a developing head cold or allergies.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-15
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Cough, Respiratory tract congestion — Feeling: GoodFree text: Cough and mild congestion, possibly a mild head cold or allergies (not suspected to be COVID-19).MedDRA releases: 2024-11 · check-in free text available
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2022-02-08
-
2022-05-10
Survey response — 6 months, dose 1, dependentMedDRA: Influenza, Nasopharyngitis, Upper respiratory tract infection — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Upper respiratory infection (flu/cold virus)MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-09 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Mild congestion and stuffy nose, possibly due to a developing head cold or allergies.
Systemic reaction (other): Cough and mild congestion, possibly a mild head cold or allergies (not suspected to be COVID-19).
Release 11 — 6 months, dose 1, dependent
Symptoms: Upper respiratory infection (flu/cold virus)
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 | Influenza | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release