69E-16976-04260
2 vaccinations
4 coded responses
19 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 05-11
- ZIP prefix
- 117 / NY
- Registered
- 2021-11-14
- Relationship
- Child or adolescent in my care
- Guardian
- 3FV-54047-74759
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-14
Registered in v-safe
-
2021-11-14
Dose 1 — Pfizer-BioNTech
- 2021-11-14
-
2021-11-15
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-11-16
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
-
2021-11-18
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Muscle or body achesAdult check-in
- 2021-11-19
- 2021-11-20
- 2021-11-21
- 2021-11-28
-
2021-12-05
Dose 2 — Pfizer-BioNTech
- 2021-12-05
-
2021-12-06
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Axillary mass — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Fatigue or tirednessFree text: Injection site arm lump in armpitMedDRA releases: 2024-11 · check-in free text available
-
2021-12-07
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Axillary mass — Feeling: Good · Site: Pain · Joint painsFree text: Lump in left armpit (injection arm)MedDRA releases: 2024-11 · check-in free text available
-
2021-12-08
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Axillary mass — Feeling: Good · Site: PainFree text: Lump in armpit of injection armMedDRA releases: 2024-11 · check-in free text available
- 2021-12-12
- 2021-12-21
-
2021-12-28
Survey response — day 21, dose 2, dependentMedDRA: Oropharyngeal pain, Pyrexia, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend schoolFree text: Fever, sore throat, congestionMedDRA releases: 2024-11 · check-in free text available
- 2022-01-09
- 2022-01-16
- 2022-03-06
- 2022-06-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-14 | Pfizer-BioNTech | No |
| 2 | 2021-12-05 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Injection site arm lump in armpit
Systemic reaction (other): Lump in left armpit (injection arm)
Systemic reaction (other): Lump in armpit of injection arm
Release 10 — day 21, dose 2, dependent
Symptoms: Fever, sore throat, congestion
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 | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Axillary mass | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release