KVB-31579-96361
3 vaccinations
3 coded responses
29 check-ins
2 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 554 / MN
- Registered
- 2021-11-13
- Relationship
- Child or adolescent in my care
- Guardian
- 5HQ-12145-89517
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-12
Dose 1 — Pfizer-BioNTech
-
2021-11-13
Registered in v-safe
-
2021-11-13
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
-
2021-11-14
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-11-15
- 2021-11-16
- 2021-11-17
- 2021-11-18
- 2021-11-19
-
2021-11-26
Survey response — day 14, dose 1, dependentMedDRA: Nasal congestion — Feeling: GoodFree text: Stuffy noseMedDRA releases: 2024-11 · check-in free text available
- 2021-12-03
-
2021-12-04
Dose 2 — Pfizer-BioNTech
- 2021-12-10
- 2021-12-11
- 2021-12-18
- 2021-12-25
- 2022-01-01
- 2022-01-08
- 2022-01-15
- 2022-03-05
-
2022-05-27
Dose 3 — Pfizer-BioNTech
-
2022-05-31
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-06-01
- 2022-06-02
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-06-24
- 2022-07-01
- 2022-07-10
- 2022-08-28
-
2022-11-25
Survey response — 6 months, dose 3, dependentMedDRA: Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Upper resp infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-11-25
Report sent to call center — 6 months, dose 3, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-28
-
2023-04-03
Call successfulParticipant prefers to complete VAERS report online
-
2023-05-27
Survey response — 12 months, dose 3, dependentMedDRA: Constipation, Dehydration, Nausea, Viral infection, Vomiting — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
- 2023-05-27
- 2023-05-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-12 | Pfizer-BioNTech | No |
| 2 | 2021-12-04 | Pfizer-BioNTech | No |
| 3 | 2022-05-27 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-25 | Successful 2023-04-03 |
Participant prefers to complete VAERS report online |
| 2023-05-27 | Unsuccessful |
Free text
Release 10 — day 14, dose 1, dependent
Symptoms: Stuffy nose
Release 12 — 6 months, dose 3, dependent
Symptoms: Upper resp infection
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 | Constipation | · | · | ✓ |
| SD | Dehydration | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release