4QV-19432-24565
3 vaccinations
2 coded responses
28 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 12-15
- ZIP prefix
- 981 / WA
- Registered
- 2021-07-31
- Relationship
- Child or adolescent in my care
- Guardian
- Y26-11151-20491
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-07-31
Registered in v-safe
-
2021-07-31
Dose 1 — Pfizer-BioNTech
-
2021-08-01
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Hiccups — Feeling: Good · Site: Pain · Muscle or body achesFree text: HiccupsMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-02
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-08-03
- 2021-08-05
- 2021-08-06
- 2021-08-07
- 2021-08-14
- 2021-08-21
- 2021-08-28
- 2021-09-05
- 2021-09-11
- 2021-10-30
-
2021-11-27
Dose 2 — Pfizer-BioNTech
- 2021-11-27
-
2021-11-28
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-11-29
- 2021-11-30
- 2021-12-01
- 2021-12-02
- 2021-12-03
- 2021-12-04
- 2021-12-13
- 2021-12-18
- 2021-12-27
- 2022-01-02
- 2022-01-08
- 2022-02-28
-
2022-05-31
Survey response — 6 months, dose 2, dependentMedDRA: Diplopia, Neck pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: New neck pain and double vision x 2-3 weeks.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-31
Report sent to call center — 6 months, dose 2, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-06-01
-
2022-06-06
Call successfulCompleted over the phone
-
2022-08-23
Dose 3 — Pfizer-BioNTech
- 2022-11-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-07-31 | Pfizer-BioNTech | No |
| 2 | 2021-11-27 | Pfizer-BioNTech | No |
| 3 | 2022-08-23 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-05-31 | Successful 2022-06-06 |
Completed over the phone |
Free text
Release 9 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Hiccups
Release 11 — 6 months, dose 2, dependent
Symptoms: New neck pain and double vision x 2-3 weeks.
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 | Diplopia | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SRO | Hiccups | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release