CB3-12075-01371
4 vaccinations
3 coded responses
52 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 027 / MA
- Registered
- 2020-12-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
TKT-11364-16615
Child or adolescent in my care · Male · 2022-06-29
Timeline
-
2020-12-16
Registered in v-safe
-
2020-12-16
Dose 1 — Pfizer-BioNTech
- 2020-12-16
- 2020-12-17
- 2020-12-18
- 2020-12-19
- 2020-12-20
- 2020-12-21
- 2020-12-22
- 2020-12-23
- 2020-12-30
-
2021-01-06
Dose 2 — Pfizer-BioNTech
- 2021-01-06
-
2021-01-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-01-08
Survey response — days 1–6 daily, dose 2MedDRA: Irritability — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: IrritabilityMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-15
- 2021-01-20
- 2021-01-27
-
2021-02-03
Survey response — day 28, dose 2MedDRA: Abdominal pain — Feeling: Good · Be unable to work, Be unable to do your normal daily activitiesFree text: Abdominal crampingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
- 2021-02-17
- 2021-04-07
- 2021-07-07
-
2021-09-28
Dose 3 — Pfizer-BioNTech
- 2021-09-28
-
2021-09-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2021-09-30
- 2021-10-01
- 2021-10-02
- 2021-10-03
- 2021-10-04
- 2021-10-05
- 2021-10-12
- 2021-10-19
- 2021-10-26
- 2021-11-02
- 2021-11-09
- 2021-12-28
- 2022-03-29
- 2022-09-28
-
2022-11-01
Dose 4 — Moderna
- 2022-11-02
- 2022-11-04
- 2022-11-05
- 2022-11-06
- 2022-11-07
- 2022-11-08
- 2022-11-15
- 2022-11-22
-
2022-11-29
Survey response — day 28, dose 4MedDRA: Asthma, Pre-existing disease — Feeling: Good · 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: Asthma exacerbation, not tested for COVID. Improved with PO Prednisone.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-29
Report sent to call center — day 28, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-30
- 2022-12-06
- 2022-12-13
- 2023-01-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-16 | Pfizer-BioNTech | |
| 2 | 2021-01-06 | Pfizer-BioNTech | |
| 3 | 2021-09-28 | Pfizer-BioNTech | No |
| 4 | 2022-11-01 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 1 — days 1–6 daily, dose 2
Systemic reaction (other): Irritability
Release 3 — day 28, dose 2
Symptoms: Abdominal cramping
Release 12 — day 28, dose 4
Symptoms: Asthma exacerbation, not tested for COVID. Improved with PO Prednisone.
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 | ✓ | ✓ | ✓ |
| SD | Asthma | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Irritability | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release