4SE-31442-73455
3 vaccinations
2 coded responses
13 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 05-11
- ZIP prefix
- 597 / MT
- Registered
- 2022-08-11
- Relationship
- Child or adolescent in my care
- Guardian
- SBT-21464-35211
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-08-11
Registered in v-safe
-
2022-08-11
Dose 1 — Pfizer-BioNTech
- 2022-08-11
- 2022-08-12
- 2022-08-14
-
2022-09-01
Dose 2 — Pfizer-BioNTech
- 2022-09-01
-
2022-09-02
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-09-12
- 2022-09-20
- 2022-10-16
-
2022-11-16
Dose 3 — Pfizer-BioNTech
-
2022-11-17
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-12-02
-
2022-12-09
Survey response — day 21, dose 3, dependentMedDRA: Abdominal discomfort, Decreased appetite, Diarrhoea, Fatigue, Pyrexia, SARS-CoV-2 test negative, Tongue coated, Tongue disorder, Trichoglossia, Vomiting — Feeling: Good · Be unable to do your normal daily activitiesFree text: Vomiting, diarrhea, stomach discomfort, extreme fatigue, fever, poor appetite and change in tongue surface (white hairy tongue). Lasted about 48 hours earlier this week and she's fully recovered. Rapid COVID test was negative.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-21
Survey response — day 35, dose 3, dependentMedDRA: Cough, Diarrhoea, Fatigue, Influenza A virus test positive, Nasal congestion, Pyrexia, Rhinorrhoea, Sneezing — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Fatigue, diarrhea, cough, sneezing, runny nose, nasal congestion, fever. Tested positive for influenza A.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-21
Report sent to call center — day 35, dose 3, dependentBe unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-12-22
Call successfulNot applicable - Accidental Reporting
- 2023-05-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-08-11 | Pfizer-BioNTech | No |
| 2 | 2022-09-01 | Pfizer-BioNTech | No |
| 3 | 2022-11-16 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-21 | Successful 2022-12-22 |
Not applicable - Accidental Reporting |
Free text
Release 12 — day 21, dose 3, dependent
Symptoms: Vomiting, diarrhea, stomach discomfort, extreme fatigue, fever, poor appetite and change in tongue surface (white hairy tongue). Lasted about 48 hours earlier this week and she's fully recovered. Rapid COVID test was negative.
Release 12 — day 35, dose 3, dependent
Symptoms: Fatigue, diarrhea, cough, sneezing, runny nose, nasal congestion, fever. Tested positive for influenza A.
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 discomfort | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Decreased appetite | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Influenza A virus test positive | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Tongue coated | · | · | ✓ |
| SD | Tongue disorder | · | · | ✓ |
| SD | Trichoglossia | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release