7KQ-10076-12124
3 vaccinations
2 coded responses
9 check-ins
2 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 12-15
- ZIP prefix
- 559 / MN
- Registered
- 2022-01-19
- Relationship
- Child or adolescent in my care
- Guardian
- XXX-81776-41599
- Race
- Other
- Ethnicity
- N/A
Timeline
-
2021-05-14
Dose 1 — Pfizer-BioNTech
-
2021-06-09
Dose 2 — Pfizer-BioNTech
-
2022-01-06
Dose 3 — Pfizer-BioNTech
-
2022-01-19
Registered in v-safe
-
2022-01-19
Health check-in — 7 day, dose 3, dependentFeeling: Fair · Fever · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-01-20
Survey response — 14 day, dose 3, dependentMedDRA: Respiratory tract infection viral, SARS-CoV-2 test — Feeling: Good · Be unable to do their normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2022-01-20
Report sent to call center — 14 day, dose 3, dependentBe unable to do their normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-01-21
-
2022-01-25
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-27
- 2022-02-04
- 2022-02-10
- 2022-02-20
-
2022-04-07
Survey response — 3 month, dose 3, dependentMedDRA: Gingivectomy, Retinal tear — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11 · check-in answers available
-
2022-04-07
Report sent to call center — 3 month, dose 3, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-04-11
- 2022-07-08
- 2023-01-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-14 | Pfizer-BioNTech | No |
| 2 | 2021-06-09 | Pfizer-BioNTech | No |
| 3 | 2022-01-06 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-20 | Successful 2022-01-25 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-04-07 | Unsuccessful |
Free text
Release 10
Symptoms: Gabe caught a respiratory virus. He was PCR tested and it came back negative. He's on the mend.
Healthcare visit (other): Got a COVID test
Release 11
Symptoms: Operculated retinal hole. I don't think it's related to the vaccine, but it needed laser treatment.
Free-text releases are not linked to a specific 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 | SARS-CoV-2 test | · | · | ✓ |
| SD | Gingivectomy | · | · | ✓ |
| SD | Respiratory tract infection viral | · | · | ✓ |
| SD | Retinal tear | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release