58Y-29093-87020
4 vaccinations
17 coded responses
47 check-ins
15 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 494 / MI
- Registered
- 2021-11-24
- Relationship
- Child or adolescent in my care
- Guardian
- GSD-33264-36037
- Race
- N/A
- Ethnicity
- N/A
Timeline
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2021-11-24
Registered in v-safe
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2021-11-24
Dose 1 — Pfizer-BioNTech
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2021-11-24
Health check-in — day 0, dose 1, dependentFeeling: Good · Site: Pain, Itching · NoneAdult check-in
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2021-11-25
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Respiratory tract congestion — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: CongestionMedDRA releases: 2024-11 · check-in free text available
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2021-11-26
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
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2021-11-27
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-11-28
- 2021-11-29
- 2021-11-30
- 2021-12-01
- 2021-12-08
- 2021-12-15
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2021-12-17
Dose 2 — Pfizer-BioNTech
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2021-12-17
Health check-in — day 0, dose 2, dependentFeeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
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2021-12-18
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-12-19
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Site: Itching · Headache, Fatigue or tiredness, NauseaAdult check-in
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2021-12-20
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-12-21
- 2021-12-23
- 2021-12-24
- 2021-12-31
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2022-01-07
Survey response — day 21, dose 2, dependentMedDRA: Cough — Feeling: FairFree text: He has a bit of a cough this afternoon.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-14
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2022-01-21
Survey response — day 35, dose 2, dependentMedDRA: Headache — Feeling: GoodFree text: Had a headache one day this week.MedDRA releases: 2024-11 · check-in free text available
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2022-01-30
Survey response — day 42, dose 2, dependentMedDRA: Chest pain, Cough, Oropharyngeal pain, Pain, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sore throat, congestion, aches, cough, chest pain. Home Covid test negative. Haven't gotten lab results yet.MedDRA releases: 2024-11 · check-in free text available
- 2022-03-20
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2022-05-27
Dose 3 — Pfizer-BioNTech
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2022-05-28
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Dizziness — Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: DizzinessMedDRA releases: 2024-11 · check-in free text available
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2022-05-29
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Axillary pain — Feeling: Good · Site: Pain, Itching · HeadacheFree text: Soreness in armpit of arm where shot was givenMedDRA releases: 2024-11 · check-in free text available
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2022-05-31
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Axillary pain — Feeling: Good · Site: ItchingFree text: Soreness in armpit of arm that got injectionMedDRA releases: 2024-11 · check-in free text available
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2022-06-01
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Axillary pain — Feeling: Good · Site: ItchingFree text: Soreness in armpit of arm with injectionMedDRA releases: 2024-11 · check-in free text available
- 2022-06-06
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2022-06-11
Survey response — day 14, dose 3, dependentMedDRA: Pre-existing disease, Respiratory tract congestion — Feeling: GoodFree text: Congestion, could be allergiesMedDRA releases: 2024-11 · check-in free text available
- 2022-06-18
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2022-06-26
Survey response — day 28, dose 3, dependentMedDRA: Cough, Dyspnoea, Wheezing — Feeling: GoodFree text: Cough. One day with wheezing and shortness of breath. I might have reported it last week; I don't remember. Mild cough went away for a couple days after wheezing and then came back.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-03
- 2022-07-08
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2022-08-26
Survey response — 3 months, dose 3, dependentMedDRA: Bronchial hyperreactivity, Dyspnoea, Office visit, Wheezing — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: He has been diagnosed with reactive airway disease in July after having a single wheezy/shortness of breath episode in June. · Healthcare visit (other): Family doc clinic apptMedDRA releases: 2024-11 · check-in free text available
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2022-08-26
Report sent to call center — 3 months, dose 3, dependentGet care from a doctor or other healthcare professional1 call case(s)
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2022-08-30
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-11-04
Dose 4 — Pfizer-BioNTechCo-administered: Flu
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2022-11-05
Survey response — days 1–6 daily, dose 4, dependentMedDRA: Arthralgia, Neck pain — Feeling: Good · Site: Pain, RednessFree text: Some pain on side of neck/top of shoulder on the same side of body as vaccine siteMedDRA releases: 2024-11 · check-in free text available
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2022-11-06
Survey response — days 1–6 daily, dose 4, dependentMedDRA: Arthralgia, Neck pain — Feeling: Good · Site: PainFree text: Pain in side of neck/top of shoulder on side of vaccination siteMedDRA releases: 2024-11 · check-in free text available
- 2022-11-08
- 2022-11-09
- 2022-11-10
- 2022-11-11
- 2022-11-18
- 2022-11-25
- 2022-12-02
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2022-12-09
Survey response — day 35, dose 4, dependentMedDRA: Body temperature increased, Cough, Nucleic acid test, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative, Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: He had a sore throat and was stuffy on 12/4, then vomited 12/5 and had a mild fever (100.2). 12/6 through 12/9, he's coughing. Rapid NAAT covid test on 12/5 was negative as were home tests on 12/7 and 12/9.MedDRA releases: 2024-11 · check-in free text available
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2022-12-17
Survey response — day 42, dose 4, dependentMedDRA: Cough, Nasopharyngitis, Pyrexia, Viral infection, Vomiting — Feeling: Good · Be unable to work or attend schoolFree text: Likely a virus. He had cold symptoms start Dec. 4 followed by vomiting Dec. 5 and a slight fever. Cough is still present today Dec. 17.MedDRA releases: 2024-11 · check-in free text available
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2023-02-03
Survey response — 3 months, dose 4, dependentMedDRA: Cough, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion — Feeling: Good · Be unable to work or attend schoolMedDRA releases: 2024-11
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2023-05-07
Survey response — 6 months, dose 4, dependentMedDRA: Cough, Nasopharyngitis — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-24 | Pfizer-BioNTech | No |
| 2 | 2021-12-17 | Pfizer-BioNTech | No |
| 3 | 2022-05-27 | Pfizer-BioNTech | No |
| 4 | 2022-11-04 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-08-26 | Successful 2022-08-30 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 10 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Congestion
Release 10 — day 21, dose 2, dependent
Symptoms: He has a bit of a cough this afternoon.
Release 10 — day 35, dose 2, dependent
Symptoms: Had a headache one day this week.
Release 11 — day 42, dose 2, dependent
Symptoms: Sore throat, congestion, aches, cough, chest pain. Home Covid test negative. Haven't gotten lab results yet.
Release 11 — days 1–6 daily, dose 3, dependent
Systemic reaction (other): Dizziness
Systemic reaction (other): Soreness in armpit of arm where shot was given
Systemic reaction (other): Soreness in armpit of arm that got injection
Systemic reaction (other): Soreness in armpit of arm with injection
Release 12 — day 14, dose 3, dependent
Symptoms: Congestion, could be allergies
Release 12 — day 28, dose 3, dependent
Symptoms: Cough. One day with wheezing and shortness of breath. I might have reported it last week; I don't remember. Mild cough went away for a couple days after wheezing and then came back.
Release 12 — 3 months, dose 3, dependent
Symptoms: He has been diagnosed with reactive airway disease in July after having a single wheezy/shortness of breath episode in June.
Healthcare visit (other): Family doc clinic appt
Release 12 — days 1–6 daily, dose 4, dependent
Systemic reaction (other): Some pain on side of neck/top of shoulder on the same side of body as vaccine site
Systemic reaction (other): Pain in side of neck/top of shoulder on side of vaccination site
Release 12 — day 35, dose 4, dependent
Symptoms: He had a sore throat and was stuffy on 12/4, then vomited 12/5 and had a mild fever (100.2). 12/6 through 12/9, he's coughing. Rapid NAAT covid test on 12/5 was negative as were home tests on 12/7 and 12/9.
Release 12 — day 42, dose 4, dependent
Symptoms: Likely a virus. He had cold symptoms start Dec. 4 followed by vomiting Dec. 5 and a slight fever. Cough is still present today Dec. 17.
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 | Body temperature increased | · | · | ✓ |
| SD | Bronchial hyperreactivity | · | · | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Nucleic acid test | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SD | Wheezing | · | · | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Neck pain | · | · | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release