5Y3-24079-40867
4 vaccinations
6 coded responses
13 check-ins
5 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 12-15
- ZIP prefix
- 926 / CA
- Registered
- 2022-09-06
- Relationship
- Child or adolescent in my care
- Guardian
- N6K-31935-70847
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-05-14
Dose 1 — Pfizer-BioNTech
-
2021-06-04
Dose 2 — Pfizer-BioNTech
-
2021-08-18
Dose 3 — Pfizer-BioNTech
-
2022-09-06
Registered in v-safe
-
2022-09-10
Dose 4 — Pfizer-BioNTechCo-administered: Flu
-
2022-09-11
Health check-in — days 1–6 daily, dose 4, dependentFeeling: Fair · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tiredness, Vomiting · Be unable to do your normal daily activitiesAdult check-in
-
2022-09-12
Health check-in — days 1–6 daily, dose 4, dependentFeeling: Good · Site: Redness, Swelling · Fatigue or tirednessAdult check-in
- 2022-09-13
-
2022-09-14
Survey response — days 1–6 daily, dose 4, dependentMedDRA: Cough — Feeling: Fair · Fatigue or tirednessFree text: Lingering cough tested for any bacterial infections ie strep throat etc has none just this lingering coughMedDRA releases: 2024-11 · check-in free text available
-
2022-09-16
Survey response — days 1–6 daily, dose 4, dependentMedDRA: Cough — Feeling: GoodFree text: Still has dry coughMedDRA releases: 2024-11 · check-in free text available
-
2022-09-17
Survey response — day 7, dose 4, dependentMedDRA: Cough — Feeling: GoodFree text: Cough has subsided nowMedDRA releases: 2024-11 · check-in free text available
- 2022-09-24
- 2022-10-01
- 2022-10-08
-
2022-10-15
Survey response — day 35, dose 4, dependentMedDRA: Office visit, Vitiligo — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Sudden onset of Vitilago loss of pigment in skin on hands feet legs · Healthcare visit (other): Referral by pediatrician to a specialist dermatologist who then diagnosed him with this condition no known cases in family historyMedDRA releases: 2024-11 · check-in free text available
-
2022-10-15
Report sent to call center — day 35, dose 4, dependentGet care from a doctor or other healthcare professional1 call case(s)
- 2022-10-17
- 2022-10-19
- 2022-10-22
-
2022-12-10
Survey response — 3 months, dose 4, dependentMedDRA: Office visit, Vitiligo — Feeling: Fair · Get care from a doctor or other healthcare professional · HospitalizationFree text: Symptoms: Developed Vitiligo on hands feet legs does not run in FA. Odd. · Healthcare visit (other): Saw specialist dermatology put him on a special cream to try and bring back pigmentMedDRA releases: 2024-11 · check-in free text available
-
2022-12-10
Report sent to call center — 3 months, dose 4, dependentGet care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
- 2022-12-13
- 2022-12-13
-
2023-03-11
Survey response — 6 months, dose 4, dependentMedDRA: Cough, SARS-CoV-2 test negative, Viral infection — Feeling: Good · Be unable to work or attend schoolMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-14 | Pfizer-BioNTech | No |
| 2 | 2021-06-04 | Pfizer-BioNTech | No |
| 3 | 2021-08-18 | Pfizer-BioNTech | No |
| 4 | 2022-09-10 | Pfizer-BioNTech | Flu |
Call center
2 call center cases
2 unsuccessful
Free text
Release 12 — days 1–6 daily, dose 4, dependent
Systemic reaction (other): Lingering cough tested for any bacterial infections ie strep throat etc has none just this lingering cough
Systemic reaction (other): Still has dry cough
Release 12 — day 7, dose 4, dependent
Systemic reaction (other): Cough has subsided now
Release 12 — day 35, dose 4, dependent
Symptoms: Sudden onset of Vitilago loss of pigment in skin on hands feet legs
Healthcare visit (other): Referral by pediatrician to a specialist dermatologist who then diagnosed him with this condition no known cases in family history
Release 12 — 3 months, dose 4, dependent
Symptoms: Developed Vitiligo on hands feet legs does not run in FA. Odd.
Healthcare visit (other): Saw specialist dermatology put him on a special cream to try and bring back pigment
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 | Cough | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SD | Vitiligo | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release