4YC-13301-87689
5 vaccinations
2 coded responses
40 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 544 / WI
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
4T2-29628-09671
Child or adolescent in my care · Female · 2022-06-28
Timeline
-
2021-01-20
Registered in v-safe
-
2021-01-20
Dose 1 — Pfizer-BioNTech
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-02-03
-
2021-02-10
Dose 2 — Pfizer-BioNTech
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-05-12
- 2021-08-11
-
2021-09-28
Dose 3 — Pfizer-BioNTech
- 2021-09-30
-
2021-10-01
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2021-10-02
- 2021-10-03
- 2021-10-04
- 2021-10-05
- 2021-10-12
- 2021-10-19
- 2021-10-26
- 2021-11-02
- 2021-11-09
- 2021-12-28
- 2022-03-29
-
2022-04-05
Dose 4 — Pfizer-BioNTech
- 2022-04-15
- 2022-04-19
- 2022-04-26
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-07-05
-
2022-09-13
Dose 5 — Pfizer-BioNTech
- 2022-10-05
- 2022-10-20
- 2022-10-25
-
2022-12-13
Survey response — 3 months, dose 5MedDRA: Chills, Cough, Malaise, Pain, Pyrexia, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Fever, cough, chills, aches and malaise. 4 days. Getting better. Granddaughter brought infection home. Covid tests neg so farMedDRA releases: 2024-11 · check-in free text available
- 2023-03-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Pfizer-BioNTech | |
| 2 | 2021-02-10 | Pfizer-BioNTech | |
| 3 | 2021-09-28 | Pfizer-BioNTech | No |
| 4 | 2022-04-05 | Pfizer-BioNTech | No |
| 5 | 2022-09-13 | Pfizer-BioNTech | No |
Free text
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): No
Release 12 — 3 months, dose 5
Symptoms: Fever, cough, chills, aches and malaise. 4 days. Getting better. Granddaughter brought infection home. Covid tests neg so far
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 | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release