AJ4-77471-24886
4 vaccinations
4 coded responses
8 check-ins
1 free-text entry
1 call case
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 775 / TX
- Registered
- 2022-12-16
- Relationship
- Child or adolescent in my care
- Guardian
- 7CA-12944-14627
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-06-14
Dose 1 — Pfizer-BioNTech
-
2021-07-06
Dose 2 — Pfizer-BioNTech
-
2022-02-22
Dose 3 — Pfizer-BioNTech
-
2022-12-08
Dose 4 — Pfizer-BioNTech
-
2022-12-16
Registered in v-safe
- 2022-12-16
- 2022-12-22
-
2022-12-29
Survey response — day 21, dose 4, dependentMedDRA: Cough, Discharge, Pyrexia, Respiratory tract congestion — Feeling: GoodFree text: Low grade fever, cough, mild congestion, mild drainage.MedDRA releases: 2024-11 · check-in free text available
-
2023-01-05
Survey response — day 28, dose 4, dependentMedDRA: Abdominal pain upper, Pyrexia, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-01-12
- 2023-01-19
-
2023-03-09
Survey response — 3 months, dose 4, dependentMedDRA: Pharyngitis streptococcal — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-03-09
Report sent to call center — 3 months, dose 4, dependentBe unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-03-10
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2023-06-08
Survey response — 6 months, dose 4, dependentMedDRA: Illness — Feeling: Good · Be unable to work or attend schoolMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-14 | Pfizer-BioNTech | No |
| 2 | 2021-07-06 | Pfizer-BioNTech | No |
| 3 | 2022-02-22 | Pfizer-BioNTech | No |
| 4 | 2022-12-08 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-03-09 | Successful 2023-03-10 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — day 21, dose 4, dependent
Symptoms: Low grade fever, cough, mild congestion, mild drainage.
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 | Discharge | · | · | ✓ |
| SD | Illness | · | · | ✓ |
| SD | Pharyngitis streptococcal | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release