ASR-15057-34954
3 vaccinations
6 coded responses
23 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 12-15
- ZIP prefix
- 230 / VA
- Registered
- 2021-07-06
- Relationship
- Child or adolescent in my care
- Guardian
- 4V5-31385-33566
- Race
- American Indian or Alaska Native
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-07-06
Registered in v-safe
-
2021-07-06
Dose 1 — Pfizer-BioNTech
-
2021-07-06
Health check-in — day 0, dose 1, dependentFeeling: Good · Site: Pain, Swelling · NoneAdult check-in
-
2021-07-07
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches · Be unable to do their normal daily activitiesFree text: Nose running with green mucusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-08
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body achesAdult check-in
- 2021-07-10
- 2021-07-12
- 2021-07-21
-
2021-07-27
Dose 2 — Pfizer-BioNTech
- 2021-07-27
-
2021-07-28
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Unevaluable event — Feeling: Poor · Site: Pain · Fever · Headache · Be unable to do their normal daily activitiesFree text: Heat rate 114MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-07-29
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Unevaluable event — Feeling: Fair · Site: Pain · HeadacheFree text: Heart rate 84MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-07-30
- 2021-07-31
- 2021-08-01
- 2021-08-02
-
2021-08-03
Health check-in — day 7, dose 2, dependentFeeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-08-10
-
2021-08-17
Survey response — day 21, dose 2, dependentMedDRA: Cough, Nasal congestion, Oropharyngeal pain, SARS-CoV-2 test — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Stuffy nose, coughing, sore throat · Healthcare visit (other): Test for CovidMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-17
Report sent to call center — day 21, dose 2, dependentGet care from a doctor or other healthcare professional1 call case(s)
- 2021-08-24
- 2021-08-24
- 2021-08-31
- 2021-09-07
- 2021-10-26
-
2022-01-02
Dose 3 — Pfizer-BioNTech
-
2022-01-25
Survey response — 6 months, dose 2, dependentMedDRA: Chills, Pyrexia — Feeling: Good · Be unable to do your normal daily activitiesFree text: Had a fever of over 101 F for about 3 hours and chills for a couple of hours.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-29
-
2023-01-02
Survey response — 12 months, dose 3, dependentMedDRA: Nasal congestion, Rhinorrhoea — Feeling: FairMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-07-06 | Pfizer-BioNTech | No |
| 2 | 2021-07-27 | Pfizer-BioNTech | No |
| 3 | 2022-01-02 | Pfizer-BioNTech | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 9 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Nose running with green mucus
Release 9 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Heat rate 114
Systemic reaction (other): Heart rate 84
Release 9 — day 21, dose 2, dependent
Release 11 — 6 months, dose 2, dependent
Symptoms: Had a fever of over 101 F for about 3 hours and chills for a couple of hours.
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 |
|---|---|---|---|---|
| HCVO | SARS-CoV-2 test | ✓ | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SD | Nasal congestion | ✓ | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release