5TV-43794-93252
4 vaccinations
9 coded responses
49 check-ins
8 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 550 / MN
- Registered
- 2021-11-26
- Relationship
- Child or adolescent in my care
- Guardian
- 5CH-29580-00736
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-26
Registered in v-safe
-
2021-11-26
Dose 1 — Pfizer-BioNTech
- 2021-11-26
- 2021-11-27
- 2021-11-28
- 2021-11-29
-
2021-11-30
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Nasal congestion — Feeling: GoodFree text: Stuffy nose but probably not related to the vaccineMedDRA releases: 2024-11 · check-in free text available
-
2021-12-01
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Nasal congestion — Feeling: GoodFree text: Stuffy nose but probably not related to the vaccineMedDRA releases: 2024-11 · check-in free text available
-
2021-12-02
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Nasal congestion — Feeling: GoodFree text: Stuffy nose but probably not related to the vaccineMedDRA releases: 2024-11 · check-in free text available
-
2021-12-03
Survey response — day 7, dose 1, dependentMedDRA: Nasal congestion — Feeling: GoodFree text: Stuffy noseMedDRA releases: 2024-11 · check-in free text available
- 2021-12-10
-
2021-12-17
Dose 2 — Pfizer-BioNTech
- 2021-12-17
-
2021-12-18
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Irritability — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: IrritabilityMedDRA releases: 2024-11 · check-in free text available
- 2021-12-19
- 2021-12-20
- 2021-12-21
- 2021-12-22
- 2021-12-23
- 2021-12-24
-
2021-12-31
Survey response — day 14, dose 2, dependentMedDRA: Influenza — Feeling: Good · Be unable to work or attend schoolFree text: Influenza A over Christmas.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-07
- 2022-01-14
- 2022-01-21
- 2022-01-28
- 2022-03-18
-
2022-06-10
Dose 3 — Pfizer-BioNTech
- 2022-06-10
- 2022-06-11
-
2022-06-12
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Axillary pain, Lymphadenopathy — Feeling: Fair · HeadacheFree text: (b)(6) complained of pain in his armpit, on the same side he got his injection. Upon palpation, I could feel an enlarged lymph node in his right axilla.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-13
- 2022-06-14
- 2022-06-15
- 2022-06-16
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2022-06-17
Survey response — day 7, dose 3, dependentMedDRA: Rash, Self-medication — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: (b)(6) actually developed the rash two days ago but I forgot to check it and last night had gotten bigger on his left chest area. Just treated it with hydrocortisone cream; he states it is not itchy.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-24
- 2022-07-01
- 2022-07-08
- 2022-07-15
- 2022-07-22
- 2022-09-11
-
2022-11-07
Dose 4 — Pfizer-BioNTech
- 2022-11-07
- 2022-11-08
- 2022-11-09
- 2022-11-13
- 2022-11-14
- 2022-11-21
- 2022-11-28
- 2022-12-05
- 2022-12-12
- 2022-12-20
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2023-02-06
Survey response — 3 months, dose 4, dependentMedDRA: Decreased appetite, Malaise, Pyrexia, Viral infection, Vomiting — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-05-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-26 | Pfizer-BioNTech | No |
| 2 | 2021-12-17 | Pfizer-BioNTech | No |
| 3 | 2022-06-10 | Pfizer-BioNTech | No |
| 4 | 2022-11-07 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Stuffy nose but probably not related to the vaccine
Systemic reaction (other): Stuffy nose but probably not related to the vaccine
Systemic reaction (other): Stuffy nose but probably not related to the vaccine
Release 10 — day 7, dose 1, dependent
Systemic reaction (other): Stuffy nose
Release 10 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Irritability
Release 10 — day 14, dose 2, dependent
Symptoms: Influenza A over Christmas.
Release 12 — days 1–6 daily, dose 3, dependent
Systemic reaction (other): (b)(6) complained of pain in his armpit, on the same side he got his injection. Upon palpation, I could feel an enlarged lymph node in his right axilla.
redacted (b)(6)
Release 12 — day 7, dose 3, dependent
Systemic reaction (other): (b)(6) actually developed the rash two days ago but I forgot to check it and last night had gotten bigger on his left chest area. Just treated it with hydrocortisone cream; he states it is not itchy.
redacted (b)(6)
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 | Decreased appetite | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Irritability | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release