KHK-31702-00975
2 vaccinations
2 coded responses
19 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 05-11
- ZIP prefix
- 670 / KS
- Registered
- 2021-11-11
- Relationship
- Child or adolescent in my care
- Guardian
- VHK-26839-99114
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-10
Dose 1 — Pfizer-BioNTech
-
2021-11-11
Registered in v-safe
-
2021-11-11
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-11-12
- 2021-11-13
- 2021-11-15
- 2021-11-16
- 2021-11-17
-
2021-11-24
Survey response — day 14, dose 1, dependentMedDRA: Nausea, Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Nausea and vomitingMedDRA releases: 2024-11 · check-in free text available
- 2021-12-01
-
2021-12-02
Dose 2 — Pfizer-BioNTech
- 2021-12-03
- 2021-12-05
- 2021-12-06
- 2021-12-07
- 2021-12-08
- 2021-12-09
- 2021-12-16
- 2021-12-23
-
2022-01-01
Survey response — day 28, dose 2, dependentMedDRA: COVID-19 pneumonia, Chest pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Pain, burning in chest: diagnosed with COVID pneumonitisMedDRA releases: 2024-11 · check-in free text available
-
2022-01-01
Report sent to call center — day 28, dose 2, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-01-05
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-06
- 2022-01-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-10 | Pfizer-BioNTech | No |
| 2 | 2021-12-02 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-01-01 | Successful 2022-01-05 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 10 — day 14, dose 1, dependent
Symptoms: Nausea and vomiting
Release 10 — day 28, dose 2, dependent
Symptoms: Pain, burning in chest: diagnosed with COVID pneumonitis
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 | Chest pain | · | · | ✓ |
| SD | COVID-19 pneumonia | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release