9QJ-14575-55499
2 vaccinations
2 coded responses
3 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 322 / FL
- Registered
- 2022-01-23
- Relationship
- Child or adolescent in my care
- Guardian
- UTY-10170-49752
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-10
Dose 1 — Pfizer-BioNTech
-
2021-12-01
Dose 2 — Pfizer-BioNTech
-
2022-01-23
Registered in v-safe
- 2022-03-02
-
2022-06-02
Survey response — 6 months, dose 2, dependentMedDRA: Influenza, Nausea, Pyrexia, SARS-CoV-2 test negative, Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Flu A last week, fever, nausea, vomiting, negative covid testMedDRA releases: 2024-11 · check-in free text available
-
2022-12-05
Survey response — 12 months, dose 2, dependentMedDRA: Gastroenteritis — 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: GastroenteritisMedDRA releases: 2024-11 · check-in free text available
-
2022-12-05
Report sent to call center — 12 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)
-
2022-12-06
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-10 | Pfizer-BioNTech | No |
| 2 | 2021-12-01 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-05 | Successful 2022-12-06 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 11 — 6 months, dose 2, dependent
Symptoms: Flu A last week, fever, nausea, vomiting, negative covid test
Release 12 — 12 months, dose 2, dependent
Symptoms: Gastroenteritis
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 | Gastroenteritis | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release