4FK-28801-67590

2 vaccinations 11 coded responses 20 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 05-11
ZIP prefix: 272 / NC
Registered: 2021-11-13

Relationship: Child or adolescent in my care
Guardian: EDZ-22560-43351
Race: White
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-11-13
Registered in v-safe
2021-11-13
Dose 1 — Pfizer-BioNTech
2021-11-13
Survey response — day 0, dose 1, dependent
MedDRA: Nasal congestion, Rhinorrhoea — Feeling: Poor · Site: Pain · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Stuffy Runny Nose

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Nasal congestion, Rhinorrhoea — Feeling: Poor · Site: Pain, Swelling · Fever · Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Stuffy Runny Nose

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Lacrimation increased, Nasal congestion, Ocular hyperaemia, Rhinorrhoea — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school

Free text: Stuffy Runny Nose with runny red eyes

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Fair · Site: Pain, Itching · Fever · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-11-18
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Flank pain — Feeling: Good · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Free text: Left side only with aches

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Chills, Joint pains, Fatigue or tiredness

Adult check-in
2021-11-20
Survey response — day 7, dose 1, dependent
MedDRA: Unevaluable event — Feeling: Good

Free text: Individual has Type 1 diabetes

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Health check-in — day 14, dose 1, dependent
Feeling: Good

Adult check-in
2021-12-04
Dose 2 — Pfizer-BioNTech
2021-12-05
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · None

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-12-13
Survey response — day 7, dose 2, dependent
MedDRA: Type 1 diabetes mellitus — Feeling: Good · Joint pains

Free text: Type 1 diabetic

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Survey response — day 14, dose 2, dependent
MedDRA: Nasopharyngitis — Feeling: Poor · Be unable to do your normal daily activities

Free text: Cold like symptoms. Mom is going to test for Covid Monday

MedDRA releases: 2024-11 · check-in free text available
2021-12-27
Survey response — day 21, dose 2, dependent
MedDRA: Nasopharyngitis — Feeling: Good · Be unable to do your normal daily activities

Free text: Possible covid19 symptoms but no test done because of uncertainty if it was just a cold was hard to tell

MedDRA releases: 2024-11 · check-in free text available
2022-01-01
Health check-in — day 28, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-10
Health check-in — day 35, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-15
Survey response — day 42, dose 2, dependent
MedDRA: Body temperature increased, Fatigue — Feeling: Fair · Be unable to work or attend school

Free text: Covid 19 infection symptoms started 1/9/21 ended 1/14/21 fever 99.5 highest and fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-03-05
Survey response — 3 months, dose 2, dependent
MedDRA: Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

Free text: Possible 3rd infection of covid at current.

MedDRA releases: 2024-11 · check-in free text available
2022-06-04
Health check-in — 6 months, dose 2, dependent
Feeling: Good

Adult check-in
2022-12-06
Survey response — 12 months, dose 2, dependent
MedDRA: Influenza, Respiratory syncytial virus infection — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: RSV 10/15/22 Influenza Type A 11/25/22

MedDRA releases: 2024-11 · check-in free text available
2022-12-06
Report sent to call center — 12 months, dose 2, dependent
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-11-13	Pfizer-BioNTech	No
2	2021-12-04	Pfizer-BioNTech	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 10 — day 0, dose 1, dependent

2021-11-13

Systemic reaction (other): Stuffy Runny Nose

Release 10 — days 1–6 daily, dose 1, dependent

2021-11-14

Systemic reaction (other): Stuffy Runny Nose

2021-11-15

Systemic reaction (other): Stuffy Runny Nose with runny red eyes

2021-11-18

Systemic reaction (other): Left side only with aches

Release 10 — day 7, dose 1, dependent

2021-11-20

Systemic reaction (other): Individual has Type 1 diabetes

Release 10 — day 7, dose 2, dependent

2021-12-13

Systemic reaction (other): Type 1 diabetic

Release 10 — day 14, dose 2, dependent

2021-12-18

Symptoms: Cold like symptoms. Mom is going to test for Covid Monday

Release 10 — day 21, dose 2, dependent

2021-12-27

Symptoms: Possible covid19 symptoms but no test done because of uncertainty if it was just a cold was hard to tell

Release 10 — day 42, dose 2, dependent

2022-01-15

Symptoms: Covid 19 infection symptoms started 1/9/21 ended 1/14/21 fever 99.5 highest and fatigue

Release 11 — 3 months, dose 2, dependent

2022-03-05

Symptoms: Possible 3rd infection of covid at current.

Release 12 — 12 months, dose 2, dependent

2022-12-06

Symptoms: RSV 10/15/22 Influenza Type A 11/25/22

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	Body temperature increased	·	·	✓
SD	Fatigue	·	·	✓
SD	Influenza	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Respiratory syncytial virus infection	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Flank pain	·	·	✓
SRO	Lacrimation increased	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Ocular hyperaemia	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Type 1 diabetes mellitus	·	·	✓
SRO	Unevaluable event	·	·	✓

✓ active code · ○ coded but marked inactive · blank = not in that release