FQZ-11803-15647

3 vaccinations 6 coded responses 34 check-ins 6 free-text entries 1 call case

Sex: Male
Age at first dose: 12-15
ZIP prefix: 801 / CO
Registered: 2021-11-13

Relationship: Child or adolescent in my care
Guardian: YWG-40458-22034
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-11-13
Registered in v-safe
2021-11-13
Dose 1 — Pfizer-BioNTech
2021-11-13
Health check-in — day 0, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-14
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-15
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-16
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Abdominal pain

Adult check-in
2021-11-17
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-18
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-20
Survey response — day 7, dose 1, dependent
MedDRA: Toothache — Feeling: Good

Free text: tooth ache

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Health check-in — day 14, dose 1, dependent
Feeling: Good

Adult check-in
2021-12-04
Dose 2 — Pfizer-BioNTech
2021-12-04
Health check-in — day 0, dose 2, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-06
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Axillary pain — Feeling: Good · Site: Pain · Headache, Muscle or body aches

Free text: Armpits are sore

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Fair · Headache

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Headache

Adult check-in
2021-12-11
Health check-in — day 7, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-18
Health check-in — day 14, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-25
Health check-in — day 21, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-01
Survey response — day 28, dose 2, dependent
MedDRA: Body temperature increased, Diarrhoea, Headache, Influenza like illness, Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: Flu like symptoms for 2 days but better now with no symptoms. had fever 100.3, multiple vomiting, diarrhea, and headace.

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Health check-in — day 35, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-15
Survey response — day 42, dose 2, dependent
MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activities

Free text: sore throat and congestion

MedDRA releases: 2024-11 · check-in free text available
2022-03-05
Health check-in — 3 months, dose 2, dependent
Feeling: Good

Adult check-in
2022-06-04
Health check-in — 6 months, dose 2, dependent
Feeling: Good

Adult check-in
2022-06-12
Dose 3 — Pfizer-BioNTech
2022-06-16
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Axillary pain, Oedema peripheral — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: swollen & sore armpit

MedDRA releases: 2024-11 · check-in free text available
2022-06-17
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-06-18
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-06-19
Health check-in — day 7, dose 3, dependent
Feeling: Fair · None

Adult check-in
2022-06-26
Health check-in — day 14, dose 3, dependent
Feeling: Good

Adult check-in
2022-07-03
Health check-in — day 21, dose 3, dependent
Feeling: Good

Adult check-in
2022-07-10
Health check-in — day 28, dose 3, dependent
Feeling: Good

Adult check-in
2022-07-17
Health check-in — day 35, dose 3, dependent
Feeling: Good

Adult check-in
2022-07-24
Survey response — day 42, dose 3, dependent
MedDRA: Influenza, Malaise, Nasopharyngitis, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Sick, cold/flu · Healthcare visit (other): Primary healthcare provider visit

MedDRA releases: 2024-11 · check-in free text available
2022-07-24
Report sent to call center — day 42, dose 3, dependent
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-25
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-11
Health check-in — 3 months, dose 3, dependent
Feeling: Good

Adult check-in
2022-12-11
Health check-in — 6 months, dose 3, dependent
Feeling: Good

Adult check-in
2023-06-12
Health check-in — 12 months, dose 3, dependent
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-11-13	Pfizer-BioNTech	No
2	2021-12-04	Pfizer-BioNTech	No
3	2022-06-12	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-07-24	Successful 2022-07-25	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 10 — day 7, dose 1, dependent

2021-11-20

Systemic reaction (other): tooth ache

Release 10 — days 1–6 daily, dose 2, dependent

2021-12-06

Systemic reaction (other): Armpits are sore

Release 10 — day 28, dose 2, dependent

2022-01-01

Symptoms: Flu like symptoms for 2 days but better now with no symptoms. had fever 100.3, multiple vomiting, diarrhea, and headace.

Release 10 — day 42, dose 2, dependent

2022-01-15

Symptoms: sore throat and congestion

Release 12 — days 1–6 daily, dose 3, dependent

2022-06-16

Systemic reaction (other): swollen & sore armpit

Release 12 — day 42, dose 3, dependent

2022-07-24

Symptoms: Sick, cold/flu

Healthcare visit (other): Primary healthcare provider visit

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	Body temperature increased	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Headache	·	·	✓
SD	Influenza	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Malaise	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Vomiting	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Toothache	·	·	✓

✓ active code · ○ coded but marked inactive · blank = not in that release