76A-17301-25724
4 vaccinations
5 coded responses
52 check-ins
3 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 05-11
- ZIP prefix
- 923 / CA
- Registered
- 2021-11-05
- Relationship
- Child or adolescent in my care
- Guardian
- Z4H-29208-32953
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-05
Registered in v-safe
-
2021-11-05
Dose 1 — Pfizer-BioNTech
- 2021-11-05
-
2021-11-06
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2021-11-07
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-11-09
- 2021-11-10
- 2021-11-11
- 2021-11-12
- 2021-11-19
- 2021-11-26
-
2021-11-27
Dose 2 — Pfizer-BioNTech
- 2021-11-27
-
2021-11-28
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Site: Pain · NoneAdult check-in
-
2021-11-29
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Pharyngitis streptococcal — Feeling: Poor · Fever · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Strep throatMedDRA releases: 2024-11 · check-in free text available
-
2021-11-29
Report sent to call center — days 1–6 daily, dose 2, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-11-30
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Streptococcal infection — Feeling: Fair · Fever · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Currently has strepMedDRA releases: 2024-11 · check-in free text available
-
2021-12-01
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Fever · None · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2021-12-02
-
2021-12-02
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-12-03
-
2021-12-04
Health check-in — day 7, dose 2, dependentFeeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-12-11
- 2021-12-18
- 2021-12-25
- 2022-01-01
- 2022-01-08
- 2022-02-26
-
2022-05-25
Dose 3 — Pfizer-BioNTech
- 2022-05-25
-
2022-05-26
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2022-05-27
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain · NoneAdult check-in
-
2022-05-28
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain, Redness, Swelling · Nausea, VomitingAdult check-in
-
2022-05-29
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain, Swelling · NoneAdult check-in
-
2022-05-30
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain, Swelling · DiarrheaAdult check-in
-
2022-05-31
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2022-06-01
Survey response — day 7, dose 3, dependentMedDRA: Aphonia — Feeling: Good · Site: Pain · HeadacheFree text: Losing her voiceMedDRA releases: 2024-11 · check-in free text available
- 2022-06-08
- 2022-06-16
- 2022-06-22
- 2022-06-29
- 2022-07-06
- 2022-08-24
-
2022-10-26
Dose 4 — Pfizer-BioNTech
- 2022-10-26
-
2022-10-27
Health check-in — days 1–6 daily, dose 4, dependentFeeling: Fair · Site: Pain, Redness, Swelling · None · Be unable to work or attend schoolAdult check-in
-
2022-10-28
Health check-in — days 1–6 daily, dose 4, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-10-29
- 2022-10-30
- 2022-10-31
- 2022-11-01
- 2022-11-02
- 2022-11-09
- 2022-11-18
- 2022-11-23
- 2022-11-30
- 2022-12-07
-
2023-01-25
Survey response — 3 months, dose 4, dependentMedDRA: SARS-CoV-2 test negative, Viral infection — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-01-25
Report sent to call center — 3 months, dose 4, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-01-26
-
2023-04-26
Survey response — 6 months, dose 4, dependentMedDRA: Pharyngitis streptococcal, Tonsillar hypertrophy — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-04-26
Report sent to call center — 6 months, dose 4, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-04-27
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2023-04-27
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-05 | Pfizer-BioNTech | No |
| 2 | 2021-11-27 | Pfizer-BioNTech | No |
| 3 | 2022-05-25 | Pfizer-BioNTech | No |
| 4 | 2022-10-26 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-29 | Successful 2021-12-02 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2023-01-25 | Successful 2023-04-27 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2023-04-26 | Successful 2023-04-27 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 10 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Strep throat
Systemic reaction (other): Currently has strep
Release 11 — day 7, dose 3, dependent
Systemic reaction (other): Losing her voice
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 | Pharyngitis streptococcal | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Tonsillar hypertrophy | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Aphonia | · | · | ✓ |
| SRO | Pharyngitis streptococcal | · | · | ✓ |
| SRO | Streptococcal infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release