5FW-26880-80223
3 vaccinations
9 coded responses
36 check-ins
9 free-text entries
4 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 481 / MI
- Registered
- 2022-03-03
- Relationship
- Child or adolescent in my care
- Guardian
- QHX-32840-96294
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-03-03
Registered in v-safe
-
2022-03-04
Dose 1 — Pfizer-BioNTech
- 2022-03-04
-
2022-03-05
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-03-06
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-03-07
- 2022-03-08
- 2022-03-09
- 2022-03-10
- 2022-03-11
- 2022-03-18
-
2022-03-25
Dose 2 — Pfizer-BioNTech
-
2022-03-25
Health check-in — day 0, dose 2, dependentFeeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-03-26
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-03-27
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · NoneAdult check-in
-
2022-03-28
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Axillary pain — Feeling: GoodFree text: Pain in armpit on injection sideMedDRA releases: 2024-11 · check-in free text available
- 2022-03-29
- 2022-03-30
- 2022-04-01
- 2022-04-08
- 2022-04-15
- 2022-04-22
- 2022-04-29
-
2022-05-06
Survey response — day 42, dose 2, dependentMedDRA: Upper respiratory tract infection — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: An upper respiratory infection - PCR test results not back yet.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-24
- 2022-09-23
-
2022-11-05
Dose 3 — Pfizer-BioNTech
-
2022-11-05
Health check-in — day 0, dose 3, dependentFeeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-11-06
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Illness — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: He likely has a new illness on top of the boosterMedDRA releases: 2024-11 · check-in free text available
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2022-11-07
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Bronchitis, Conjunctivitis, Ear infection — Feeling: Poor · Fever · Chills, Fatigue or tiredness · 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 visitFree text: He has a bilateral ear infection, conjunctivitis, and bronchitisMedDRA releases: 2024-11 · check-in free text available
-
2022-11-07
Report sent to call center — days 1–6 daily, dose 3, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-08
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Infection — Feeling: Poor · Fever · Chills, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Diagnosed with a secondary infection unrelated to the vaccineMedDRA releases: 2024-11 · check-in free text available
- 2022-11-08
-
2022-11-08
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-11-09
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Illness — Feeling: Poor · Fever · Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: (b)(6) has a non-Covid illnessMedDRA releases: 2024-11 · check-in free text available
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2022-11-10
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Illness — Feeling: Poor · Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Has a non Covid illnessMedDRA releases: 2024-11 · check-in free text available
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2022-11-10
Report sent to call center — days 1–6 daily, dose 3, dependentBe unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-11
- 2022-11-19
- 2022-11-26
-
2022-12-03
Survey response — day 28, dose 3, dependentMedDRA: COVID-19, Ear infection — Feeling: Poor · 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 visitFree text: Covid diagnosis + ear infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-12-03
Report sent to call center — day 28, dose 3, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-05
- 2022-12-05
- 2022-12-10
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2022-12-19
Survey response — day 42, dose 3, dependentMedDRA: COVID-19, Upper respiratory tract infection — Feeling: Poor · 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 visitFree text: A series of upper respiratory infections, including CovidMedDRA releases: 2024-11 · check-in free text available
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2022-12-19
Report sent to call center — day 42, dose 3, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-20
- 2022-12-20
- 2022-12-20
- 2023-02-04
- 2023-05-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-03-04 | Pfizer-BioNTech | No |
| 2 | 2022-03-25 | Pfizer-BioNTech | No |
| 3 | 2022-11-05 | Pfizer-BioNTech | No |
Call center
4 call center cases
1 successful · 3 unsuccessful
Free text
Release 11 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Pain in armpit on injection side
Release 11 — day 42, dose 2, dependent
Symptoms: An upper respiratory infection - PCR test results not back yet.
Release 12 — days 1–6 daily, dose 3, dependent
Systemic reaction (other): He likely has a new illness on top of the booster
Systemic reaction (other): He has a bilateral ear infection, conjunctivitis, and bronchitis
Systemic reaction (other): Diagnosed with a secondary infection unrelated to the vaccine
Systemic reaction (other): Has a non Covid illness
Release 12 — day 28, dose 3, dependent
Symptoms: Covid diagnosis + ear infection
Release 12 — day 42, dose 3, dependent
Symptoms: A series of upper respiratory infections, including Covid
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 | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Bronchitis | · | · | ✓ |
| SRO | Conjunctivitis | · | · | ✓ |
| SRO | Ear infection | · | · | ✓ |
| SRO | Illness | · | · | ✓ |
| SRO | Infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release