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JC9-18419-55526

4 vaccinations 1 coded response 10 check-ins 1 free-text entry 0 call cases
Sex
Male
Age at first dose
12-15
ZIP prefix
945 / CA
Registered
2022-11-15
Relationship
Child or adolescent in my care
Guardian
5V3-43612-10897
Race
Multiracial
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-05-12
    Dose 1 — Pfizer-BioNTech
  2. 2021-06-02
    Dose 2 — Pfizer-BioNTech
  3. 2022-01-10
    Dose 3 — Pfizer-BioNTech
  4. 2022-11-14
    Dose 4 — Pfizer-BioNTech
  5. 2022-11-15
    Registered in v-safe
  6. 2022-11-15
    Survey response — days 1–6 daily, dose 4, dependent
    MedDRA: Chest discomfort, Respiratory disorder — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Chest/breathing a little different after walking one block today.
    MedDRA releases: 2024-11 · check-in free text available
  7. 2022-11-16
    Health check-in — days 1–6 daily, dose 4, dependent
    Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities
    Adult check-in
  8. 2022-11-22
    Health check-in — day 7, dose 4, dependent
    Feeling: Good · None
    Adult check-in
  9. 2022-11-28
    Health check-in — day 14, dose 4, dependent
    Feeling: Good
    Adult check-in
  10. 2022-12-05
    Health check-in — day 21, dose 4, dependent
    Feeling: Good
    Adult check-in
  11. 2022-12-13
    Health check-in — day 28, dose 4, dependent
    Feeling: Good
    Adult check-in
  12. 2022-12-20
    Health check-in — day 35, dose 4, dependent
    Feeling: Good
    Adult check-in
  13. 2022-12-28
    Health check-in — day 42, dose 4, dependent
    Feeling: Good
    Adult check-in
  14. 2023-02-13
  15. 2023-05-15

Vaccinations

DoseDateManufacturerCo-administered
12021-05-12Pfizer-BioNTech No
22021-06-02Pfizer-BioNTech No
32022-01-10Pfizer-BioNTech No
42022-11-14Pfizer-BioNTech No

Free text

Release 12 — days 1–6 daily, dose 4, dependent

2022-11-15

Systemic reaction (other): Chest/breathing a little different after walking one block today.

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

FieldPreferred term2021-092023-042024-11
SROChest discomfort · · ✓
SRORespiratory disorder · · ✓

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

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