LTU-30728-00054
3 vaccinations
3 coded responses
26 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 921 / CA
- Registered
- 2021-11-08
- Relationship
- Child or adolescent in my care
- Guardian
- BQE-23905-76891
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-08
Registered in v-safe
-
2021-11-08
Dose 1 — Pfizer-BioNTech
- 2021-11-08
-
2021-11-09
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Irritability — Feeling: Fair · Fatigue or tirednessFree text: CrankyMedDRA releases: 2024-11 · check-in free text available
-
2021-11-10
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Pain in extremity, Unevaluable event — Feeling: Good · Muscle or body aches, Fatigue or tirednessFree text: Claims of pain in toe, but may be have injured himself (low verbal)MedDRA releases: 2024-11 · check-in free text available
- 2021-11-13
- 2021-11-14
- 2021-11-16
- 2021-11-22
- 2021-12-01
- 2021-12-08
-
2021-12-10
Dose 2 — Pfizer-BioNTech
- 2021-12-13
-
2021-12-15
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Abdominal pain upper, Pre-existing disease — Feeling: Good · Abdominal painFree text: William does have a disease, eoe, that could be the source of stomach painMedDRA releases: 2024-11 · check-in free text available
- 2021-12-16
- 2021-12-19
- 2021-12-24
- 2022-01-03
- 2022-01-07
- 2022-01-16
- 2022-01-21
- 2022-03-11
- 2022-06-15
-
2022-06-24
Dose 3 — Pfizer-BioNTech
- 2022-07-08
- 2022-07-17
- 2022-07-22
- 2022-07-30
- 2022-08-07
- 2023-06-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-08 | Pfizer-BioNTech | No |
| 2 | 2021-12-10 | Pfizer-BioNTech | No |
| 3 | 2022-06-24 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Cranky
Systemic reaction (other): Claims of pain in toe, but may be have injured himself (low verbal)
Release 10 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): William does have a disease, eoe, that could be the source of stomach pain
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 | Abdominal pain upper | · | · | ✓ |
| SRO | Irritability | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release