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JWA-31090-11412

2 vaccinations 2 coded responses 16 check-ins 2 free-text entries 0 call cases
Sex
Male
Age at first dose
05-11
ZIP prefix
322 / FL
Registered
2021-11-09
Relationship
Child or adolescent in my care
Guardian
YX6-15351-13313
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-11-09
    Registered in v-safe
  2. 2021-11-09
    Dose 1 — Pfizer-BioNTech
  3. 2021-11-09
    Health check-in — day 0, dose 1, dependent
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-11-14
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  5. 2021-11-15
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  6. 2021-11-17
    Health check-in — day 7, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  7. 2021-11-25
    Health check-in — day 14, dose 1, dependent
    Feeling: Good
    Adult check-in
  8. 2021-11-30
    Dose 2 — Pfizer-BioNTech
  9. 2021-12-01
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  10. 2021-12-02
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities
    Adult check-in
  11. 2021-12-03
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  12. 2021-12-06
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Good · None
    Adult check-in
  13. 2021-12-09
    Survey response — day 7, dose 2, dependent
    MedDRA: Aphthous ulcer — Feeling: Good
    Free text: Both (b)(6) and I (his mom) got canker (canquer?) on the inside of our lips. I wouldn't mention it except that we both got it after the shots on our "Labial frenulum" (yes I had to look that up)the inside part that connects lip to gum.
    MedDRA releases: 2024-11 · check-in free text available
  14. 2021-12-15
    Health check-in — day 14, dose 2, dependent
    Feeling: Good
    Adult check-in
  15. 2021-12-21
    Health check-in — day 21, dose 2, dependent
    Feeling: Good
    Adult check-in
  16. 2022-01-04
    Health check-in — day 35, dose 2, dependent
    Feeling: Good
    Adult check-in
  17. 2022-01-13
    Health check-in — day 42, dose 2, dependent
    Feeling: Good
    Adult check-in
  18. 2022-03-01
  19. 2022-05-31
    Survey response — 6 months, dose 2, dependent
    MedDRA: COVID-19, Chills, Pyrexia — Feeling: Good · Be unable to work or attend school
    Free text: Covid, fever, chills
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-11-09Pfizer-BioNTech No
22021-11-30Pfizer-BioNTech No

Free text

Release 10 — day 7, dose 2, dependent

2021-12-09

Systemic reaction (other): Both (b)(6) and I (his mom) got canker (canquer?) on the inside of our lips. I wouldn't mention it except that we both got it after the shots on our "Labial frenulum" (yes I had to look that up)the inside part that connects lip to gum.
redacted (b)(6)

Release 11 — 6 months, dose 2, dependent

2022-05-31

Symptoms: Covid, fever, chills

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
SDChills · · ✓
SDCOVID-19 · · ✓
SDPyrexia · · ✓
SROAphthous ulcer · · ✓

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