JFC-79410-72936

4 vaccinations 3 coded responses 52 check-ins 2 free-text entries 1 call case

Sex: Male
Age at first dose: 05-11
ZIP prefix: 923 / CA
Registered: 2021-11-05

Relationship: Child or adolescent in my care
Guardian: Z4H-29208-32953
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-11-05
Registered in v-safe
2021-11-05
Dose 1 — Pfizer-BioNTech
2021-11-05
Health check-in — day 0, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-10
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

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

Adult check-in
2021-11-12
Health check-in — day 7, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-19
Health check-in — day 14, dose 1, dependent
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 21, dose 1, dependent
Feeling: Good

Adult check-in
2021-11-27
Dose 2 — Pfizer-BioNTech
2021-11-27
Health check-in — day 0, dose 2, dependent
Feeling: Fair · Site: Pain · None

Adult check-in
2021-11-28
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Fair · Site: Pain · None

Adult check-in
2021-11-29
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-11-30
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-01
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-04
Survey response — day 7, dose 2, dependent
MedDRA: Ankle fracture — Feeling: Good · 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 visit

Free text: Broke his ankle 2 days ago

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Report sent to call center — day 7, dose 2, dependent
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-11
Health check-in — day 14, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-18
Health check-in — day 21, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-25
Health check-in — day 28, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-01
Health check-in — day 35, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-08
Health check-in — day 42, dose 2, dependent
Feeling: Good

Adult check-in
2022-02-26
Survey response — 3 months, dose 2, dependent
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Covid in January

MedDRA releases: 2024-11 · check-in free text available
2022-05-25
Dose 3 — Pfizer-BioNTech
2022-05-25
Health check-in — day 0, dose 3, dependent
Feeling: Good · Fever · None

Adult check-in
2022-05-26
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2022-05-27
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-28
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-29
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-05-30
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-05-31
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-06-01
Health check-in — day 7, dose 3, dependent
Feeling: Good · None

Adult check-in
2022-06-08
Health check-in — day 14, dose 3, dependent
Feeling: Good

Adult check-in
2022-06-16
Health check-in — day 21, dose 3, dependent
Feeling: Good

Adult check-in
2022-06-22
Health check-in — day 28, dose 3, dependent
Feeling: Good

Adult check-in
2022-06-29
Health check-in — day 35, dose 3, dependent
Feeling: Good

Adult check-in
2022-07-06
Health check-in — day 42, dose 3, dependent
Feeling: Good

Adult check-in
2022-08-24
Health check-in — 3 months, dose 3, dependent
Feeling: Good

Adult check-in
2022-10-26
Dose 4 — Pfizer-BioNTech
Co-administered: HPV
2022-10-26
Health check-in — day 0, dose 4, dependent
Feeling: Good · None

Adult check-in
2022-10-27
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2022-10-28
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-29
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · None

Adult check-in
2022-10-30
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · None

Adult check-in
2022-10-31
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · None

Adult check-in
2022-11-01
Health check-in — days 1–6 daily, dose 4, dependent
Feeling: Good · None

Adult check-in
2022-11-02
Health check-in — day 7, dose 4, dependent
Feeling: Good · None

Adult check-in
2022-11-09
Health check-in — day 14, dose 4, dependent
Feeling: Good

Adult check-in
2022-11-18
Health check-in — day 21, dose 4, dependent
Feeling: Good

Adult check-in
2022-11-23
Health check-in — day 28, dose 4, dependent
Feeling: Good

Adult check-in
2022-11-30
Health check-in — day 35, dose 4, dependent
Feeling: Good

Adult check-in
2022-12-07
Health check-in — day 42, dose 4, dependent
Feeling: Good

Adult check-in
2023-01-25
Health check-in — 3 months, dose 4, dependent
Feeling: Good

Adult check-in
2023-04-26
Survey response — 6 months, dose 4, dependent
MedDRA: Anosmia — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-11-05	Pfizer-BioNTech	No
2	2021-11-27	Pfizer-BioNTech	No
3	2022-05-25	Pfizer-BioNTech	No
4	2022-10-26	Pfizer-BioNTech	HPV

Call center

Reported	Outcome	VAERS-related outcome
2021-12-04	Successful 2021-12-07	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 10 — day 7, dose 2, dependent

2021-12-04

Systemic reaction (other): Broke his ankle 2 days ago

Release 11 — 3 months, dose 2, dependent

2022-02-26

Symptoms: Covid in January

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	Anosmia	·	·	✓
SD	COVID-19	·	·	✓
SRO	Ankle fracture	·	·	✓

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