QHX-27120-01924
4 vaccinations
4 coded responses
34 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 865 / AZ
- Registered
- 2021-11-05
- Relationship
- Child or adolescent in my care
- Guardian
- 6U3-30700-66210
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-03
Dose 1 — Pfizer-BioNTech
-
2021-11-05
Registered in v-safe
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-12
- 2021-11-17
- 2021-11-24
-
2021-11-30
Dose 2 — Pfizer-BioNTech
-
2021-12-01
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-12-02
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Site: Pain · Fever · Fatigue or tirednessAdult check-in
- 2021-12-03
- 2021-12-04
- 2021-12-05
- 2021-12-14
- 2021-12-21
- 2021-12-28
- 2022-01-04
- 2022-01-13
-
2022-05-20
Dose 3 — Pfizer-BioNTech
- 2022-05-31
- 2022-06-20
- 2022-06-24
- 2022-07-01
- 2022-08-19
-
2022-10-14
Dose 4 — Moderna
- 2022-10-15
- 2022-10-16
- 2022-10-17
- 2022-10-18
- 2022-10-19
- 2022-10-20
-
2022-10-21
Health check-in — day 7, dose 4, dependentFeeling: Poor · Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2022-10-28
Survey response — day 14, dose 4, dependentMedDRA: Cough, Rhinorrhoea, Viral infection — Feeling: Fair · Be unable to work or attend schoolFree text: Viral illness, protracted cough, runny noseMedDRA releases: 2024-11 · check-in free text available
-
2022-11-04
Survey response — day 21, dose 4, dependentMedDRA: Cough — Feeling: GoodFree text: CoughMedDRA releases: 2024-11 · check-in free text available
- 2022-11-18
-
2022-11-25
Survey response — day 42, dose 4, dependentMedDRA: Cough — Feeling: GoodFree text: Continued chronic cough, slightly worse over last few daysMedDRA releases: 2024-11 · check-in free text available
- 2023-01-15
-
2023-04-14
Survey response — 6 months, dose 4, dependentMedDRA: Cough, Sneezing — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-03 | Pfizer-BioNTech | No |
| 2 | 2021-11-30 | Pfizer-BioNTech | No |
| 3 | 2022-05-20 | Pfizer-BioNTech | No |
| 4 | 2022-10-14 | Moderna | No |
Free text
Release 12 — day 14, dose 4, dependent
Symptoms: Viral illness, protracted cough, runny nose
Release 12 — day 21, dose 4, dependent
Symptoms: Cough
Release 12 — day 42, dose 4, dependent
Symptoms: Continued chronic cough, slightly worse over last few days
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 | Rhinorrhoea | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release