5TV-20689-19522
2 vaccinations
4 coded responses
13 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 12-15
- ZIP prefix
- 919 / CA
- Registered
- 2021-07-02
- Relationship
- Child or adolescent in my care
- Guardian
- 2LN-33405-47809
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-06-09
Dose 1 — Pfizer-BioNTech
-
2021-06-30
Dose 2 — Pfizer-BioNTech
-
2021-07-02
Registered in v-safe
-
2021-07-02
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Autism spectrum disorder, Lennox-Gastaut syndrome, Pre-existing disease — Feeling: GoodFree text: He is Autistic and has Lennox Gastaut.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-03
Survey response — days 1–6 daily, dose 2, dependentMedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-04
- 2021-07-05
-
2021-07-07
Survey response — day 7, dose 2, dependentMedDRA: Rhinorrhoea — Feeling: GoodFree text: Runny nose - mildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-14
- 2021-07-21
- 2021-07-28
- 2021-08-04
- 2021-08-11
-
2021-09-29
Survey response — 3 months, dose 2, dependentMedDRA: Hydrocele, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Hydrocyle - dont believe its related at all. It just said any new health issues.MedDRA releases: 2024-11 · check-in free text available
-
2021-09-29
Report sent to call center — 3 months, dose 2, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-05
- 2021-12-29
- 2022-06-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-09 | Pfizer-BioNTech | No |
| 2 | 2021-06-30 | Pfizer-BioNTech | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 9 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): He is Autistic and has Lennox Gastaut.
Systemic reaction (other): No
Release 9 — day 7, dose 2, dependent
Systemic reaction (other): Runny nose - mild
Release 9 — 3 months, dose 2, dependent
Symptoms: Hydrocyle - dont believe its related at all. It just said any new health issues.
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 | Hydrocele | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Autism spectrum disorder | ○ | ✓ | ○ |
| SRO | Lennox-Gastaut syndrome | ○ | ✓ | ○ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release