CP4-15446-57563
3 vaccinations
3 coded responses
7 check-ins
2 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 05-11
- ZIP prefix
- 086 / NJ
- Registered
- 2022-06-28
- Relationship
- Child or adolescent in my care
- Guardian
- 258-49232-51792
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-24
Dose 1 — Pfizer-BioNTech
-
2021-12-15
Dose 2 — Pfizer-BioNTech
-
2022-06-03
Dose 3 — Pfizer-BioNTech
-
2022-06-28
Registered in v-safe
- 2022-06-28
- 2022-07-01
- 2022-07-08
- 2022-07-15
-
2022-09-02
Survey response — 3 months, dose 3, dependentMedDRA: Influenza — 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: (b)(6) got influenza in April 7thMedDRA releases: 2024-11 · check-in free text available
-
2022-09-02
Report sent to call center — 3 months, dose 3, dependentBe 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)
-
2022-09-06
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-12-04
Survey response — 6 months, dose 3, dependentMedDRA: Nasopharyngitis — Feeling: Fair · Be unable to work or attend schoolFree text: She got a cold virusMedDRA releases: 2024-11 · check-in free text available
-
2023-06-05
Survey response — 12 months, dose 3, dependentMedDRA: Office visit, Pre-existing disease, Visual impairment — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
- 2023-06-05
- 2023-06-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-24 | Pfizer-BioNTech | No |
| 2 | 2021-12-15 | Pfizer-BioNTech | No |
| 3 | 2022-06-03 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-09-02 | Successful 2022-09-06 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2023-06-05 | Unsuccessful |
Free text
Release 12 — 3 months, dose 3, dependent
Release 12 — 6 months, dose 3, dependent
Symptoms: She got a cold virus
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 | Office visit | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Visual impairment | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release