4FV-33293-96987

3 vaccinations 13 coded responses 30 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 0-4
ZIP prefix: 481 / MI
Registered: 2022-06-28

Relationship: Child or adolescent in my care
Guardian: 2BW-32058-44748
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2022-06-28
Registered in v-safe
2022-06-28
Dose 1 — Pfizer-BioNTech
2022-06-28
Health check-in — day 0, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2022-06-29
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2022-06-30
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2022-07-01
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Anger, Behaviour disorder, Defiant behaviour, Irritability, Screaming — Feeling: Fair

Free text: Behavioral issues including screaming, irritability, defiance, anger

MedDRA releases: 2024-11 · check-in free text available
2022-07-02
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-03
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-04
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Abnormal behaviour, Irritability — Feeling: Good

Free text: Continues to be grouchy, argumentative and defiant. These are abnormal for this kid.

MedDRA releases: 2024-11 · check-in free text available
2022-07-05
Health check-in — day 7, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-12
Health check-in — day 14, dose 1, dependent
Feeling: Fair

Adult check-in
2022-07-19
Dose 2 — Pfizer-BioNTech
2022-07-21
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2022-07-22
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Irritability — Feeling: Fair · Joint pains, Fatigue or tiredness

Free text: Irritability

MedDRA releases: 2024-11 · check-in free text available
2022-07-23
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-24
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Muscle or body aches

Adult check-in
2022-07-25
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-26
Health check-in — day 7, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-08-04
Health check-in — day 14, dose 2, dependent
Feeling: Good

Adult check-in
2022-08-09
Survey response — day 21, dose 2, dependent
MedDRA: Body temperature increased, Fatigue, Insomnia, Loss of personal independence in daily activities, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fever, fatigue, sleeplessness. Sent home from school today with 100.3 fever, one child at school yesterday had a positive antigen test today but was not present today. PCR test completed today, waiting on results.

MedDRA releases: 2024-11 · check-in free text available
2022-08-16
Survey response — day 28, dose 2, dependent
MedDRA: Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Recurrent and persistent left lower leg pain

MedDRA releases: 2024-11 · check-in free text available
2022-08-16
Report sent to call center — day 28, dose 2, dependent
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-17
Call 1 — Left Voicemail
2022-08-23
Survey response — day 35, dose 2, dependent
MedDRA: Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Worsening lower leg pain in left shin

MedDRA releases: 2024-11 · check-in free text available
2022-08-23
Report sent to call center — day 35, dose 2, dependent
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-24
Call 2 — Could Not Reach Participant
2022-08-24
Call 1 — Could Not Reach Participant
2022-08-29
Call 3 — Could Not Reach Participant
2022-08-29
Call 2 — Could Not Reach Participant
2022-09-01
Survey response — day 42, dose 2, dependent
MedDRA: Office visit, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Continues to have left lower leg pain, physician stated there appears to be no injury, recommended holding off on blood tests/scans until 4YO wellness visit, introduced FloraDix for extra iron in the event that it could be growing pains.

MedDRA releases: 2024-11 · check-in free text available
2022-09-19
Dose 3 — Pfizer-BioNTech
2022-09-20
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2022-09-21
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Site: Itching · Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-09-22
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-09-23
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-09-24
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-09-25
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Oropharyngeal pain, Rhinorrhoea, Sneezing — Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Runny nose, sneezing, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-09-26
Survey response — day 7, dose 3, dependent
MedDRA: Cough, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school

Free text: Runny nose, cough, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Survey response — day 14, dose 3, dependent
MedDRA: Abdominal pain, Cough, Decreased appetite, Ear infection, Paranasal sinus hypersecretion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Cough, ear infection, sinus drainage, tummy hurts, decrease in appetite

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Report sent to call center — day 14, dose 3, dependent
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-06
Call successful
Does not wish to fill out VAERS report
2022-10-06
Call successful
Does not wish to fill out VAERS report
2022-10-06
Call successful
Does not wish to fill out VAERS report
2022-10-12
Survey response — day 21, dose 3, dependent
MedDRA: Pain in extremity — Feeling: Fair

Free text: Continues to complain of lower leg pain.

MedDRA releases: 2024-11 · check-in free text available
2023-03-20
Survey response — 6 months, dose 3, dependent
MedDRA: COVID-19, Cough — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2022-06-28	Pfizer-BioNTech	No
2	2022-07-19	Pfizer-BioNTech	No
3	2022-09-19	Pfizer-BioNTech	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 12 — days 1–6 daily, dose 1, dependent

2022-07-01

Systemic reaction (other): Behavioral issues including screaming, irritability, defiance, anger

2022-07-04

Systemic reaction (other): Continues to be grouchy, argumentative and defiant. These are abnormal for this kid.

Release 12 — days 1–6 daily, dose 2, dependent

2022-07-22

Systemic reaction (other): Irritability

Release 12 — day 21, dose 2, dependent

2022-08-09

Symptoms: Fever, fatigue, sleeplessness. Sent home from school today with 100.3 fever, one child at school yesterday had a positive antigen test today but was not present today. PCR test completed today, waiting on results.

Release 12 — day 28, dose 2, dependent

2022-08-16

Symptoms: Recurrent and persistent left lower leg pain

Release 12 — day 35, dose 2, dependent

2022-08-23

Symptoms: Worsening lower leg pain in left shin

Release 12 — day 42, dose 2, dependent

2022-09-01

Symptoms: Continues to have left lower leg pain, physician stated there appears to be no injury, recommended holding off on blood tests/scans until 4YO wellness visit, introduced FloraDix for extra iron in the event that it could be growing pains.

Release 12 — days 1–6 daily, dose 3, dependent

2022-09-24

Systemic reaction (other): Sore throat

2022-09-25

Systemic reaction (other): Runny nose, sneezing, sore throat

Release 12 — day 7, dose 3, dependent

2022-09-26

Systemic reaction (other): Runny nose, cough, sore throat

Release 12 — day 14, dose 3, dependent

2022-10-05

Symptoms: Cough, ear infection, sinus drainage, tummy hurts, decrease in appetite

Release 12 — day 21, dose 3, dependent

2022-10-12

Symptoms: Continues to complain of lower leg pain.

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	Abdominal pain	·	·	✓
SD	Body temperature increased	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Ear infection	·	·	✓
SD	Fatigue	·	·	✓
SD	Insomnia	·	·	✓
SD	Loss of personal independence in daily activities	·	·	✓
SD	Office visit	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Abnormal behaviour	·	·	✓
SRO	Anger	·	·	✓
SRO	Behaviour disorder	·	·	✓
SRO	Cough	·	·	✓
SRO	Defiant behaviour	·	·	✓
SRO	Irritability	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Screaming	·	·	✓
SRO	Sneezing	·	·	✓

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