8GK-24012-43271
2 vaccinations
3 coded responses
17 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 379 / TN
- Registered
- 2021-11-12
- Relationship
- Child or adolescent in my care
- Guardian
- 4XZ-29095-14095
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-12
Registered in v-safe
-
2021-11-12
Dose 1 — Pfizer-BioNTech
- 2021-11-12
-
2021-11-13
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
-
2021-11-14
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-11-16
- 2021-11-17
- 2021-11-18
- 2021-11-19
- 2021-11-26
-
2021-12-03
Dose 2 — Pfizer-BioNTech
- 2021-12-10
-
2021-12-17
Survey response — day 14, dose 2, dependentMedDRA: Body temperature increased, Cough, Nasopharyngitis, Respiratory tract congestion, Vomiting — Feeling: Fair · Be unable to work or attend schoolFree text: Simon is experiencing cold symptoms. Congestion, coughing, fever of 100deg, vomited once. Other's in the family with the same symptoms have tested NEGATIVE for COVID PCR tests. No known exposure to COVID.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-24
- 2021-12-31
- 2022-01-07
- 2022-01-16
-
2022-03-04
Survey response — 3 months, dose 2, dependentMedDRA: Loss of personal independence in daily activities, Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend schoolFree text: He has been out of school a couple of times for cold symptoms. All Covid tests were negative.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-06
-
2022-12-05
Survey response — 12 months, dose 2, dependentMedDRA: Laboratory test abnormal, Loss of personal independence in daily activities — Feeling: Good · Be unable to work or attend schoolFree text: He had a positive at home test in September so we kept him home from school. He did not really have symptoms.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-12 | Pfizer-BioNTech | No |
| 2 | 2021-12-03 | Pfizer-BioNTech | No |
Free text
Release 10 — day 14, dose 2, dependent
Symptoms: Simon is experiencing cold symptoms. Congestion, coughing, fever of 100deg, vomited once. Other's in the family with the same symptoms have tested NEGATIVE for COVID PCR tests. No known exposure to COVID.
Release 11 — 3 months, dose 2, dependent
Symptoms: He has been out of school a couple of times for cold symptoms. All Covid tests were negative.
Release 12 — 12 months, dose 2, dependent
Symptoms: He had a positive at home test in September so we kept him home from school. He did not really have symptoms.
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 | Body temperature increased | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Laboratory test abnormal | · | · | ✓ |
| SD | Loss of personal independence in daily activities | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release