LG3-10433-09360
3 vaccinations
2 coded responses
6 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 065 / CT
- Registered
- 2022-09-17
- Relationship
- Child or adolescent in my care
- Guardian
- 79N-23659-19116
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-03-02
Dose 1 — Pfizer-BioNTech
-
2022-03-23
Dose 2 — Pfizer-BioNTech
-
2022-08-27
Dose 3 — Pfizer-BioNTech
-
2022-09-17
Registered in v-safe
- 2022-09-17
-
2022-09-24
Survey response — day 28, dose 3, dependentMedDRA: Inflammation, Injection site swelling, Joint range of motion decreased, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activitiesFree text: My shoulder was affected by the swelling at the vaccine sight. I lost some range of motion with inflammation.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-01
Survey response — day 35, dose 3, dependentMedDRA: Cough, Secretion discharge — Feeling: FairFree text: Cough and mucous.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-08
- 2022-11-27
- 2023-02-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-03-02 | Pfizer-BioNTech | No |
| 2 | 2022-03-23 | Pfizer-BioNTech | No |
| 3 | 2022-08-27 | Pfizer-BioNTech | No |
Free text
Release 12 — day 28, dose 3, dependent
Symptoms: My shoulder was affected by the swelling at the vaccine sight. I lost some range of motion with inflammation.
Release 12 — day 35, dose 3, dependent
Symptoms: Cough and mucous.
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 | Inflammation | · | · | ✓ |
| SD | Injection site swelling | · | · | ✓ |
| SD | Joint range of motion decreased | · | · | ✓ |
| SD | Secretion discharge | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release