9DY-18210-57967
2 vaccinations
1 coded response
24 check-ins
1 free-text entry
1 call case
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 662 / KS
- Registered
- 2021-12-22
- Relationship
- Child or adolescent in my care
- Guardian
- ZXM-10642-52396
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-12-22
Registered in v-safe
-
2021-12-22
Dose 1 — Pfizer-BioNTech
- 2021-12-22
- 2021-12-23
- 2021-12-24
- 2021-12-25
- 2021-12-26
- 2021-12-27
- 2021-12-28
- 2021-12-29
- 2022-01-05
-
2022-01-12
Dose 2 — Pfizer-BioNTech
- 2022-01-12
- 2022-01-13
- 2022-01-15
- 2022-01-16
- 2022-01-17
- 2022-01-18
- 2022-01-19
- 2022-01-26
- 2022-02-02
- 2022-02-09
- 2022-02-16
- 2022-02-25
-
2022-04-13
Survey response — 3 months, dose 2, dependentMedDRA: Blood urine present, Haematuria — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Hematuria. Blood in his urine.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-13
Report sent to call center — 3 months, dose 2, dependentGet care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2022-04-20
Call successfulParticipant prefers to complete VAERS report online
- 2022-07-13
- 2023-01-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-12-22 | Pfizer-BioNTech | No |
| 2 | 2022-01-12 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-04-13 | Successful 2022-04-20 |
Participant prefers to complete VAERS report online |
Free text
Release 11 — 3 months, dose 2, dependent
Symptoms: Hematuria. Blood in his urine.
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 | Blood urine present | · | · | ✓ |
| SD | Haematuria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release