KVX-17685-60153
1 vaccination
1 coded response
6 check-ins
1 free-text entry
1 call case
- Sex
- Male
- Age at first dose
- 12-15
- ZIP prefix
- 480 / MI
- Registered
- 2021-06-27
- Relationship
- Child or adolescent in my care
- Guardian
- 2DE-20216-31102
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-06-26
Dose 1 — Pfizer-BioNTech
-
2021-06-27
Registered in v-safe
-
2021-06-27
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Emergency care, Fall, Syncope — Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to do their normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: He fainted and his pediatrician recommended we go to the emergency room. Fell on the floor. And then I almost fainted again at the ER.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-27
Report sent to call center — days 1–6 daily, dose 1, dependentBe unable to do their normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-28
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-06-29
-
2021-06-29
Call successfulReported to VAERS voluntarily prior to GDIT contact
- 2021-06-30
- 2021-07-03
- 2021-07-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-26 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 9 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): He fainted and his pediatrician recommended we go to the emergency room. Fell on the floor. And then I almost fainted again at the ER.
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 |
|---|---|---|---|---|
| SRO | Emergency care | ✓ | ✓ | ✓ |
| SRO | Fall | ✓ | ✓ | ✓ |
| SRO | Syncope | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release