9BW-94126-23970
2 vaccinations
3 coded responses
16 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 623 / IL
- Registered
- 2021-11-29
- Relationship
- Child or adolescent in my care
- Guardian
- 4LN-49384-65497
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-08
Dose 1 — Pfizer-BioNTech
-
2021-11-29
Registered in v-safe
-
2021-11-29
Dose 2 — Pfizer-BioNTech
-
2021-11-29
Survey response — day 0, dose 2, dependentMedDRA: Unevaluable event — Feeling: GoodFree text: Had influenza vaccine 11/3/2021MedDRA releases: 2024-11 · check-in free text available
-
2021-11-30
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-12-01
- 2021-12-02
- 2021-12-03
- 2021-12-04
- 2021-12-05
- 2021-12-06
- 2021-12-13
- 2021-12-20
- 2021-12-27
- 2022-01-03
- 2022-01-10
-
2022-02-28
Survey response — 3 months, dose 2, dependentMedDRA: Pyrexia, Rhinorrhoea — Feeling: Good · Be unable to work or attend schoolFree text: Fever. Runny nose.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-30
Survey response — 6 months, dose 2, dependentMedDRA: Asthma, Emergency care, Influenza, Pre-existing disease — Feeling: Good · Be unable to do their normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Influenza A. Required ER visit for racemic epinephrine. He has had asthma since before 2019 but this is the first time in years has had to have ER visit for it.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-30
Report sent to call center — 6 months, dose 2, dependentBe unable to do their normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-06-01
-
2022-06-01
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-11-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-08 | Pfizer-BioNTech | No |
| 2 | 2021-11-29 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 10 — day 0, dose 2, dependent
Systemic reaction (other): Had influenza vaccine 11/3/2021
Release 11 — 3 months, dose 2, dependent
Symptoms: Fever. Runny nose.
Release 11 — 6 months, dose 2, dependent
Symptoms: Influenza A. Required ER visit for racemic epinephrine. He has had asthma since before 2019 but this is the first time in years has had to have ER visit for it.
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 | Asthma | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release