94Q-11730-01034
2 vaccinations
2 coded responses
5 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 950 / CA
- Registered
- 2022-01-15
- Relationship
- Child or adolescent in my care
- Guardian
- SPY-14777-03720
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-20
Dose 1 — Pfizer-BioNTech
-
2021-12-11
Dose 2 — Pfizer-BioNTech
-
2022-01-15
Registered in v-safe
- 2022-01-15
- 2022-01-22
- 2022-03-12
-
2022-06-11
Survey response — 6 months, dose 2, dependentMedDRA: Cough, Oropharyngeal pain, Rhinorrhoea — 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 · Outpatient clinic or urgent care clinic visitFree text: Sore throat, cough, running noseMedDRA releases: 2024-11 · check-in free text available
-
2022-06-11
Report sent to call center — 6 months, 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)
- 2022-06-13
-
2022-12-13
Survey response — 12 months, dose 2, dependentMedDRA: Abdominal pain upper, Cough, Headache, Influenza like illness, Nasopharyngitis, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Be unable to work or attend schoolFree text: Flu/cold like symptoms, including sore throat, headache, stomach ache, running nose and coughMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-20 | Pfizer-BioNTech | No |
| 2 | 2021-12-11 | Pfizer-BioNTech | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 12 — 6 months, dose 2, dependent
Symptoms: Sore throat, cough, running nose
Release 12 — 12 months, dose 2, dependent
Symptoms: Flu/cold like symptoms, including sore throat, headache, stomach ache, running nose and cough
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 | Abdominal pain upper | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release