576-70461-67977

2 vaccinations 9 coded responses 23 check-ins 9 free-text entries 1 call case

Sex: Male
Age at first dose: 05-11
ZIP prefix: 494 / MI
Registered: 2021-11-08

Relationship: Child or adolescent in my care
Guardian: ZRN-75434-53991
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-11-08
Registered in v-safe
2021-11-08
Dose 1 — Pfizer-BioNTech
2021-11-08
Health check-in — day 0, dose 1, dependent
Feeling: Good · Site: Pain, Redness · Headache

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-11-11
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: Pain

Free text: Swelling/soreness in arm pit on injection side

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Axillary pain, Injection site reaction — Feeling: Good

Free text: Still some soreness in his arm pit on the injection site.

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Survey response — days 1–6 daily, dose 1, dependent
MedDRA: Axillary pain — Feeling: Good

Free text: Still some pain in the arm pit of injection side

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-15
Survey response — day 7, dose 1, dependent
MedDRA: Cough — Feeling: Good

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — day 14, dose 1, dependent
MedDRA: Cough, Fatigue, Influenza virus test negative, Nasopharyngitis, Respiratory symptom, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good

Free text: Upper respiratory illness (probably from a cold), tested and was negative for covid, flu, & strep. Symptoms: horrible cough, congestion, runny nose, fatigue.

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Dose 2 — Pfizer-BioNTech
2021-11-30
Health check-in — day 0, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-01
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Axillary pain — Feeling: Good · Headache, Fatigue or tiredness, Abdominal pain

Free text: Pain in his armpit (the same side he got the vaccine).

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Site: Redness · None

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Site: Redness · None

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-06
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Palpitations — Feeling: Fair · Headache, Abdominal pain · Be unable to do your normal daily activities

Free text: Racing heart

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Health check-in — day 7, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-14
Survey response — day 14, dose 2, dependent
MedDRA: Abdominal pain upper, Diarrhoea, Pyrexia, Sleep disorder, Vomiting — Feeling: Fair · Be unable to work or attend school

Free text: Stomach pain, low grade fever, not able to sleep due to pain, vomiting, diarrhea.

MedDRA releases: 2024-11 · check-in free text available
2021-12-21
Health check-in — day 21, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-28
Health check-in — day 28, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-04
Health check-in — day 35, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-11
Health check-in — day 42, dose 2, dependent
Feeling: Good

Adult check-in
2022-03-01
Survey response — 3 months, dose 2, dependent
MedDRA: Fatigue, Headache, Nasopharyngitis, Office visit, Oropharyngeal pain, Pharyngeal swelling, Speech disorder — 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: Symptoms: Sore throat, swollen throat, barley talk, cold symptoms, extreme fatigue, headache. · Healthcare visit (other): Also saw PCP a few days later for it.

MedDRA releases: 2024-11 · check-in free text available
2022-03-01
Report sent to call center — 3 months, dose 2, 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)
2022-03-03
Call 1 — Left Voicemail
2022-05-31
Health check-in — 6 months, dose 2, dependent
Feeling: Good

Adult check-in
2022-11-30
Health check-in — 12 months, dose 2, dependent
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-11-08	Pfizer-BioNTech	No
2	2021-11-30	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-03-01	Unsuccessful

Free text

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

2021-11-11

Systemic reaction (other): Swelling/soreness in arm pit on injection side

2021-11-12

Systemic reaction (other): Still some soreness in his arm pit on the injection site.

2021-11-13

Systemic reaction (other): Still some pain in the arm pit of injection side

Release 10 — day 7, dose 1, dependent

2021-11-15

Systemic reaction (other): Cough

Release 10 — day 14, dose 1, dependent

2021-11-22

Symptoms: Upper respiratory illness (probably from a cold), tested and was negative for covid, flu, & strep. Symptoms: horrible cough, congestion, runny nose, fatigue.

Release 10 — days 1–6 daily, dose 2, dependent

2021-12-01

Systemic reaction (other): Pain in his armpit (the same side he got the vaccine).

2021-12-06

Systemic reaction (other): Racing heart

Release 10 — day 14, dose 2, dependent

2021-12-14

Symptoms: Stomach pain, low grade fever, not able to sleep due to pain, vomiting, diarrhea.

Release 11 — 3 months, dose 2, dependent

2022-03-01

Symptoms: Sore throat, swollen throat, barley talk, cold symptoms, extreme fatigue, headache.

Healthcare visit (other): Also saw PCP a few days later for it.

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
HCVO	Office visit	·	·	✓
SD	Abdominal pain upper	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Influenza virus test negative	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pharyngeal swelling	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory symptom	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sleep disorder	·	·	✓
SD	Speech disorder	·	·	✓
SD	Vomiting	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Cough	·	·	✓
SRO	Injection site reaction	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Palpitations	·	·	✓

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