NVQ-83629-18164

3 vaccinations 4 coded responses 35 check-ins 4 free-text entries 1 call case

Sex: Male
Age at first dose: 0-4
ZIP prefix: 038 / NH
Registered: 2022-06-27

Relationship: Child or adolescent in my care
Guardian: 55F-22613-69111
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2022-06-27
Registered in v-safe
2022-06-27
Dose 1 — Pfizer-BioNTech
2022-06-27
Health check-in — day 0, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-06-28
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-06-29
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-06-30
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-01
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-02
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-03
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-04
Health check-in — day 7, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-11
Health check-in — day 14, dose 1, dependent
Feeling: Good

Adult check-in
2022-07-18
Dose 2 — Pfizer-BioNTech
2022-07-18
Health check-in — day 0, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-19
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-07-20
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Axillary pain — Feeling: Good · Site: Pain

Free text: He's saying his armpit on the arm that received the shot is sore

MedDRA releases: 2024-11 · check-in free text available
2022-07-21
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-07-22
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-23
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-24
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-25
Health check-in — day 7, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-08-01
Health check-in — day 14, dose 2, dependent
Feeling: Good

Adult check-in
2022-08-08
Health check-in — day 21, dose 2, dependent
Feeling: Good

Adult check-in
2022-08-15
Health check-in — day 28, dose 2, dependent
Feeling: Good

Adult check-in
2022-08-22
Health check-in — day 35, dose 2, dependent
Feeling: Good

Adult check-in
2022-08-29
Health check-in — day 42, dose 2, dependent
Feeling: Good

Adult check-in
2022-09-16
Dose 3 — Pfizer-BioNTech
2022-09-17
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-09-19
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-09-20
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-09-21
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-09-22
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Lyme disease, Office visit — Feeling: Good · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Dr office visit; diagnosed with Stage 2 disseminated lyme disease

MedDRA releases: 2024-11 · check-in free text available
2022-09-22
Report sent to call center — days 1–6 daily, dose 3, dependent
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-23
Survey response — day 7, dose 3, dependent
MedDRA: Lyme disease — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Diagnosed yesterday with Early Disseminated Lyme Disease

MedDRA releases: 2024-11 · check-in free text available
2022-09-23
Call 1 — Left Voicemail
2022-09-30
Health check-in — day 14, dose 3, dependent
Feeling: Good

Adult check-in
2022-10-07
Health check-in — day 21, dose 3, dependent
Feeling: Good

Adult check-in
2022-10-14
Health check-in — day 28, dose 3, dependent
Feeling: Good

Adult check-in
2022-10-21
Survey response — day 35, dose 3, dependent
MedDRA: Cough, Nasopharyngitis, Sinus disorder — Feeling: Good

Free text: Seasonal cold with sinus issues and coughing.

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Health check-in — day 42, dose 3, dependent
Feeling: Good

Adult check-in
2022-12-16
Health check-in — 3 months, dose 3, dependent
Feeling: Good

Adult check-in
2023-03-17
Health check-in — 6 months, dose 3, dependent
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2022-06-27	Pfizer-BioNTech	No
2	2022-07-18	Pfizer-BioNTech	No
3	2022-09-16	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-09-22	Unsuccessful

Free text

Release 12 — days 1–6 daily, dose 2, dependent

2022-07-20

Systemic reaction (other): He's saying his armpit on the arm that received the shot is sore

Release 12 — days 1–6 daily, dose 3, dependent

2022-09-22

Healthcare visit (other): Dr office visit; diagnosed with Stage 2 disseminated lyme disease

Release 12 — day 7, dose 3, dependent

2022-09-23

Systemic reaction (other): Diagnosed yesterday with Early Disseminated Lyme Disease

Release 12 — day 35, dose 3, dependent

2022-10-21

Symptoms: Seasonal cold with sinus issues and coughing.

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
HCVO	Lyme disease	·	·	✓
HCVO	Office visit	·	·	✓
SD	Cough	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Sinus disorder	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Lyme disease	·	·	✓

✓ active code · ○ coded but marked inactive · blank = not in that release