JJM-21109-38339
2 vaccinations
4 coded responses
23 check-ins
3 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 038 / NH
- Registered
- 2022-01-22
- Relationship
- Child or adolescent in my care
- Guardian
- 9QF-60501-73794
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-01-21
Dose 1 — Pfizer-BioNTech
-
2022-01-22
Registered in v-safe
- 2022-01-22
-
2022-01-23
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Redness · HeadacheAdult check-in
- 2022-01-24
- 2022-01-25
- 2022-01-26
- 2022-01-28
- 2022-02-04
-
2022-02-11
Dose 2 — Pfizer-BioNTech
- 2022-02-11
- 2022-02-12
- 2022-02-13
- 2022-02-14
- 2022-02-15
- 2022-02-16
- 2022-02-17
- 2022-02-18
- 2022-02-25
- 2022-03-04
-
2022-03-11
Survey response — day 28, dose 2, dependentMedDRA: Cough, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: GoodFree text: Runny nose and mild cough for 2-3 days. Covid antigen test negative.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-18
Survey response — day 35, dose 2, dependentMedDRA: Cough, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend schoolFree text: Runny nose, congestion, cough. Covid antigen negative on day 3.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-25
Survey response — day 42, dose 2, dependentMedDRA: Ear infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Ear infection, improving with antibioticsMedDRA releases: 2024-11 · check-in free text available
-
2022-03-25
Report sent to call center — day 42, dose 2, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-03-29
-
2022-03-30
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-05-13
- 2022-08-12
-
2023-02-13
Survey response — 12 months, dose 2, dependentMedDRA: Pharyngitis streptococcal, Viral infection — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-02-13
Report sent to call center — 12 months, dose 2, dependentBe unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-02-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-01-21 | Pfizer-BioNTech | No |
| 2 | 2022-02-11 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-25 | Successful 2022-03-30 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2023-02-13 | Successful 2023-02-14 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 11 — day 28, dose 2, dependent
Symptoms: Runny nose and mild cough for 2-3 days. Covid antigen test negative.
Release 11 — day 35, dose 2, dependent
Symptoms: Runny nose, congestion, cough. Covid antigen negative on day 3.
Release 11 — day 42, dose 2, dependent
Symptoms: Ear infection, improving with antibiotics
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 | Ear infection | · | · | ✓ |
| SD | Pharyngitis streptococcal | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release