57Z-24709-80821
4 vaccinations
1 coded response
13 check-ins
1 free-text entry
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 193 / PA
- Registered
- 2021-11-22
- Relationship
- Child or adolescent in my care
- Guardian
- ZDZ-24035-25652
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-04
Dose 1 — Pfizer-BioNTech
-
2021-11-22
Registered in v-safe
- 2021-11-22
-
2021-11-26
Dose 2 — Pfizer-BioNTech
- 2021-11-27
-
2021-11-30
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-12-01
- 2021-12-03
- 2021-12-10
-
2022-05-28
Survey response — 6 months, dose 2, dependentMedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Confirmed COVID on 5/13MedDRA releases: 2024-11 · check-in free text available
-
2022-08-13
Dose 3 — Pfizer-BioNTech
- 2022-08-14
- 2022-08-15
- 2022-08-16
- 2022-08-17
- 2022-08-29
- 2022-09-19
-
2022-10-17
Dose 4 — Moderna
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-04 | Pfizer-BioNTech | No |
| 2 | 2021-11-26 | Pfizer-BioNTech | No |
| 3 | 2022-08-13 | Pfizer-BioNTech | No |
| 4 | 2022-10-17 | Moderna | No |
Free text
Release 11 — 6 months, dose 2, dependent
Symptoms: Confirmed COVID on 5/13
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 | COVID-19 | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release