DA4-22748-53806
4 vaccinations
3 coded responses
45 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 05-11
- ZIP prefix
- 501 / IA
- Registered
- 2021-11-05
- Relationship
- Child or adolescent in my care
- Guardian
- 5YD-68713-65746
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-05
Registered in v-safe
-
2021-11-05
Dose 1 — Pfizer-BioNTech
- 2021-11-05
-
2021-11-06
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-11-07
- 2021-11-08
- 2021-11-09
- 2021-11-11
- 2021-11-12
- 2021-11-19
-
2021-11-26
Dose 2 — Pfizer-BioNTech
- 2021-11-26
- 2021-11-27
- 2021-11-28
- 2021-11-30
- 2021-12-01
- 2021-12-02
- 2021-12-03
- 2021-12-11
- 2021-12-17
- 2021-12-25
- 2021-12-31
- 2022-01-07
-
2022-02-25
Survey response — 3 months, dose 2, dependentMedDRA: COVID-19, Exposure to SARS-CoV-2, Headache, Rhinorrhoea, SARS-CoV-2 test negative, Sneezing — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Runny nose, then headache, then sneezing (12 hours after onset, positive test for covid using rapid BinaxNow.) symptoms/positive approximately 72 hours after likely exposure.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-29
-
2022-05-31
Dose 3 — Pfizer-BioNTech
- 2022-05-31
- 2022-06-01
- 2022-06-02
- 2022-06-03
- 2022-06-04
- 2022-06-06
- 2022-06-07
- 2022-06-17
- 2022-06-21
- 2022-06-28
- 2022-07-05
-
2022-07-12
Survey response — day 42, dose 3, dependentMedDRA: Fatigue, Respiratory tract congestion — Feeling: FairFree text: Congestion, tirednessMedDRA releases: 2024-11 · check-in free text available
- 2022-08-30
-
2022-10-18
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-10-18
- 2022-10-20
- 2022-10-25
- 2022-11-01
-
2022-11-08
Survey response — day 21, dose 4, dependentMedDRA: Abdominal pain, Blood blister, Ear infection, Hand-foot-and-mouth disease, Influenza virus test negative, Pain, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Fever, abdominal pain, body aches, red blisters. Negative for covid/RSV/flu/strep with diagnosis of ear infection and hand/foot/mouth.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-08
Report sent to call center — day 21, 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)
- 2022-11-09
- 2022-11-18
- 2022-11-22
- 2022-12-01
- 2023-01-17
- 2023-04-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-05 | Pfizer-BioNTech | No |
| 2 | 2021-11-26 | Pfizer-BioNTech | No |
| 3 | 2022-05-31 | Pfizer-BioNTech | No |
| 4 | 2022-10-18 | Pfizer-BioNTech | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-08 | Unsuccessful |
Free text
Release 11 — 3 months, dose 2, dependent
Symptoms: Runny nose, then headache, then sneezing (12 hours after onset, positive test for covid using rapid BinaxNow.) symptoms/positive approximately 72 hours after likely exposure.
Release 12 — day 42, dose 3, dependent
Symptoms: Congestion, tiredness
Release 12 — day 21, dose 4, dependent
Symptoms: Fever, abdominal pain, body aches, red blisters. Negative for covid/RSV/flu/strep with diagnosis of ear infection and hand/foot/mouth.
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 | Blood blister | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Hand-foot-and-mouth disease | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Influenza virus test negative | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release