64S-28366-11872
3 vaccinations
7 coded responses
26 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 12-15
- ZIP prefix
- 606 / IL
- Registered
- 2021-08-13
- Relationship
- Child or adolescent in my care
- Guardian
- YWV-20687-86873
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-08-13
Registered in v-safe
-
2021-08-14
Dose 1 — Pfizer-BioNTech
-
2021-08-15
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-08-16
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Nausea, Vomiting, Diarrhea, Abdominal painAdult check-in
-
2021-08-17
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Vomiting, DiarrheaAdult check-in
-
2021-08-18
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Nausea, Abdominal painAdult check-in
-
2021-08-28
Survey response — day 14, dose 1, dependentMedDRA: Diarrhoea — Feeling: GoodFree text: DiarrheaMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-04
Dose 2 — Pfizer-BioNTech
- 2021-09-04
-
2021-09-05
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do their normal daily activitiesAdult check-in
-
2021-09-07
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Headache, Fatigue or tiredness · Be unable to do their normal daily activitiesAdult check-in
- 2021-09-09
- 2021-09-10
- 2021-09-11
- 2021-09-18
- 2021-09-25
- 2021-10-02
- 2021-10-11
- 2021-10-16
- 2021-12-04
-
2022-01-28
Dose 3 — Pfizer-BioNTech
- 2022-02-05
- 2022-02-11
- 2022-02-20
-
2022-02-26
Survey response — day 28, dose 3, dependentMedDRA: Abdominal discomfort, Pain, Pruritus, Rash — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Soreness, itching, rash on face, upset stomachMedDRA releases: 2024-11 · check-in free text available
-
2022-03-06
Survey response — day 35, dose 3, dependentMedDRA: Back pain, Injection site pain, Muscle spasms, Nausea, Rash — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Back pain, nauseous, cramps, sore near injection site and rash on forehead and chest.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-11
Survey response — day 42, dose 3, dependentMedDRA: Abdominal pain upper, Back pain, Injection site pain, Pain in extremity, Rash — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Rash on face, stomach cramps, back and leg pain and soreness near injection site.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-29
Survey response — 3 months, dose 3, dependentMedDRA: Dry mouth, Sneezing — Feeling: GoodFree text: Sneezing and dry mouthMedDRA releases: 2024-11 · check-in free text available
-
2022-07-29
Survey response — 6 months, dose 3, dependentMedDRA: Cough, Fatigue, Oropharyngeal pain — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sore throat, cough and fatigue.MedDRA releases: 2024-11 · check-in free text available
-
2023-01-28
Survey response — 12 months, dose 3, dependentMedDRA: Stomatitis — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-14 | Pfizer-BioNTech | No |
| 2 | 2021-09-04 | Pfizer-BioNTech | No |
| 3 | 2022-01-28 | Pfizer-BioNTech | No |
Free text
Release 9 — day 14, dose 1, dependent
Symptoms: Diarrhea
Release 11 — day 28, dose 3, dependent
Symptoms: Soreness, itching, rash on face, upset stomach
Release 11 — day 35, dose 3, dependent
Symptoms: Back pain, nauseous, cramps, sore near injection site and rash on forehead and chest.
Release 11 — day 42, dose 3, dependent
Symptoms: Rash on face, stomach cramps, back and leg pain and soreness near injection site.
Release 11 — 3 months, dose 3, dependent
Symptoms: Sneezing and dry mouth
Release 12 — 6 months, dose 3, dependent
Symptoms: Sore throat, cough and fatigue.
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 | Abdominal discomfort | · | · | ✓ |
| SD | Abdominal pain upper | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Diarrhoea | ✓ | · | ✓ |
| SD | Dry mouth | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Injection site pain | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Stomatitis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release