87A-21924-49401
2 vaccinations
4 coded responses
24 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 152 / PA
- Registered
- 2021-11-05
- Relationship
- Child or adolescent in my care
- Guardian
- ZXU-84088-01483
- 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
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Rhinorrhoea, Self-medication, Upper respiratory tract infection — Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to work or attend schoolFree text: Runny nose. Likely caught another URI, unrelated to vaccine. Temp taken after being given Motrin.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-07
Survey response — days 1–6 daily, dose 1, dependentMedDRA: SARS-CoV-2 test, SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Systemic reaction (other): URI, related to vaccine. Rapid OTC covid test negative · Healthcare visit (other): Have to get PCR covid test to return to school tomorrowMedDRA releases: 2024-11 · check-in free text available
-
2021-11-07
Report sent to call center — days 1–6 daily, dose 1, dependentGet care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2021-11-08
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Rhinorrhoea, Upper respiratory tract infection — Feeling: Good · Be unable to work or attend schoolFree text: Sniffles. Almost done with his URIMedDRA releases: 2024-11 · check-in free text available
-
2021-11-09
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Nasal congestion, Upper respiratory tract infection — Feeling: Good · Be unable to work or attend schoolFree text: Stuffy nose from other URIMedDRA releases: 2024-11 · check-in free text available
- 2021-11-09
- 2021-11-11
- 2021-11-12
- 2021-11-12
- 2021-11-19
-
2021-11-26
Dose 2 — Pfizer-BioNTech
- 2021-11-26
- 2021-11-27
- 2021-11-28
- 2021-11-29
- 2021-11-30
- 2021-12-01
- 2021-12-02
- 2021-12-03
- 2021-12-10
- 2021-12-17
- 2021-12-24
- 2021-12-31
- 2022-01-07
- 2022-02-25
- 2022-05-27
- 2022-11-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-05 | Pfizer-BioNTech | No |
| 2 | 2021-11-26 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-11-07 | Unsuccessful |
Free text
Release 10 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Runny nose. Likely caught another URI, unrelated to vaccine. Temp taken after being given Motrin.
Systemic reaction (other): URI, related to vaccine. Rapid OTC covid test negative
Healthcare visit (other): Have to get PCR covid test to return to school tomorrow
Systemic reaction (other): Sniffles. Almost done with his URI
Systemic reaction (other): Stuffy nose from other URI
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 | SARS-CoV-2 test | · | · | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
| SRO | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Upper respiratory tract infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release