H8A-66019-83347
4 vaccinations
5 coded responses
25 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 961 / CA
- Registered
- 2021-11-11
- Relationship
- Child or adolescent in my care
- Guardian
- SBT-21464-35211
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-11
Registered in v-safe
-
2021-11-11
Dose 1 — Pfizer-BioNTech
- 2021-11-11
-
2021-11-13
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Pain — Feeling: Good · Site: PainFree text: He said his pain is very minimal this morning, almost gone.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-14
- 2021-11-17
- 2021-11-18
-
2021-12-03
Dose 2 — Pfizer-BioNTechCo-administered: Flu
- 2021-12-03
- 2021-12-05
-
2021-12-06
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Pain — Feeling: Good · Site: PainFree text: Extremely mild pain. Expect it will be gone tomorrow.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-07
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Dry skin, Pruritus, Rash — Feeling: Good · Site: ItchingFree text: He says it's been itchy since day 1. Both flu & COVID injections were in the same arm. Today there's a light rash, probably just from scratching. He also has dry skin.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-27
- 2022-01-02
- 2022-01-17
-
2022-06-04
Survey response — 6 months, dose 2, dependentMedDRA: Cough, Fatigue, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: COVID - tested positive 5/23/22. Extreme fatigue, fever, vomiting, congestion, dry cough. Confirmed with a PCR and his rapid tests was still positive (but very faint and fading each day) on 6/3.MedDRA releases: 2024-11 · check-in free text available
-
2022-08-11
Dose 3 — Pfizer-BioNTech
- 2022-08-11
-
2022-08-12
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-08-14
- 2022-09-01
- 2022-09-12
- 2022-09-20
-
2022-10-16
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-10-16
-
2022-10-18
Health check-in — days 1–6 daily, dose 4, dependentFeeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-10-30
-
2022-11-17
Survey response — day 28, dose 4, dependentMedDRA: Fatigue, Nasal congestion, Nasopharyngitis, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: GoodFree text: Had a basic cold with stuffy/runny nose, sore throat, fatigue. Rapid COVID test and mom's PCR and flu tests were negative. Fully recovered.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-22
- 2023-01-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-11 | Pfizer-BioNTech | No |
| 2 | 2021-12-03 | Pfizer-BioNTech | Flu |
| 3 | 2022-08-11 | Pfizer-BioNTech | No |
| 4 | 2022-10-16 | Pfizer-BioNTech | Flu |
Free text
Release 10 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): He said his pain is very minimal this morning, almost gone.
Release 10 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Extremely mild pain. Expect it will be gone tomorrow.
Systemic reaction (other): He says it's been itchy since day 1. Both flu & COVID injections were in the same arm. Today there's a light rash, probably just from scratching. He also has dry skin.
Release 11 — 6 months, dose 2, dependent
Symptoms: COVID - tested positive 5/23/22. Extreme fatigue, fever, vomiting, congestion, dry cough. Confirmed with a PCR and his rapid tests was still positive (but very faint and fading each day) on 6/3.
Release 12 — day 28, dose 4, dependent
Symptoms: Had a basic cold with stuffy/runny nose, sore throat, fatigue. Rapid COVID test and mom's PCR and flu tests were negative. Fully recovered.
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 | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Dry skin | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pruritus | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release