F36-23922-37700
3 vaccinations
2 coded responses
35 check-ins
2 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 486 / MI
- Registered
- 2021-11-12
- Relationship
- Child or adolescent in my care
- Guardian
- 9CS-29345-34401
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-10
Dose 1 — Pfizer-BioNTech
-
2021-11-12
Registered in v-safe
- 2021-11-12
- 2021-11-13
- 2021-11-14
- 2021-11-15
- 2021-11-16
- 2021-11-17
- 2021-11-26
-
2021-12-01
Dose 2 — Pfizer-BioNTech
-
2021-12-02
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-12-03
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-12-04
- 2021-12-05
- 2021-12-06
- 2021-12-07
- 2021-12-08
- 2021-12-15
-
2021-12-22
Survey response — day 21, dose 2, dependentMedDRA: Type 1 diabetes mellitus — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: 12/20/21 diagnosed with type 1 diabetesMedDRA releases: 2024-11 · check-in free text available
-
2021-12-22
Report sent to call center — day 21, dose 2, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2021-12-23
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-12-29
Survey response — day 28, dose 2, dependentMedDRA: Type 1 diabetes mellitus — Feeling: Fair · Be unable to work or attend school, 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: Recent diagnosis type 1 diabetesMedDRA releases: 2024-11 · check-in free text available
-
2021-12-29
Report sent to call center — day 28, dose 2, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-01-03
Call successfulParticipant prefers to complete VAERS report online
- 2022-01-05
- 2022-01-12
- 2022-03-02
- 2022-06-01
-
2022-07-13
Dose 3 — Moderna
- 2022-07-14
- 2022-07-15
- 2022-07-16
- 2022-07-17
- 2022-07-18
- 2022-07-19
- 2022-07-20
- 2022-07-27
- 2022-08-03
- 2022-08-10
- 2022-08-19
- 2022-08-24
- 2022-10-12
- 2023-01-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-10 | Pfizer-BioNTech | No |
| 2 | 2021-12-01 | Pfizer-BioNTech | No |
| 3 | 2022-07-13 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 10 — day 21, dose 2, dependent
Symptoms: 12/20/21 diagnosed with type 1 diabetes
Release 10 — day 28, dose 2, dependent
Symptoms: Recent diagnosis type 1 diabetes
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 | Type 1 diabetes mellitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release