QQK-11467-92853

2 vaccinations 5 coded responses 12 check-ins 5 free-text entries 2 call cases

Sex: —
Age at first dose: 12-15
ZIP prefix: 109 / NY
Registered: 2021-07-21

Relationship: Child or adolescent in my care
Guardian: 2ZN-18922-70401
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-06-29
Dose 1 — Pfizer-BioNTech
2021-07-21
Registered in v-safe
2021-07-21
Dose 2 — Pfizer-BioNTech
2021-07-21
Health check-in — day 0, dose 2, dependent
Feeling: Fair · Site: Pain, Redness · None

Adult check-in
2021-07-22
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do their normal daily activities

Adult check-in
2021-07-23
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Fair · Site: Pain · Chills, Headache, Abdominal pain

Adult check-in
2021-07-24
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-07-25
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-07-26
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Thoat sore

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-13
Survey response — day 21, dose 2, dependent
MedDRA: Headache — Feeling: Good · Be unable to do their normal daily activities

Free text: Three days ago very bad headache, didnt want to be awake.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-18
Health check-in — day 28, dose 2, dependent
Feeling: Good

Adult check-in
2021-09-01
Health check-in — day 42, dose 2, dependent
Feeling: Good

Adult check-in
2021-10-20
Survey response — 3 months, dose 2, dependent
MedDRA: Cough, Office visit, SARS-CoV-2 test, SARS-CoV-2 test negative, Vomiting — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Mya has a cough that isn't much better in ten days and she's periodically vomiting. Rapid strep test negative, waiting for more detailed one. Covid test negative. · Healthcare visit (other): Visited doctor for strep and Covid tests

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
Report sent to call center — 3 months, dose 2, dependent
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-10-21
Call 1 — Left Voicemail
2021-10-21
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-19
Survey response — 6 months, dose 2, dependent
MedDRA: Asthenia, Exposure to SARS-CoV-2, Feeling abnormal, Medical counselling, Pyrexia, Vomiting — Feeling: Fair · Be unable to do their normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: (b)(6) was with a person who had contact with a known COVID case. We are awaiting PCR results. (b)(6) vomited 1ce Monday night w a low fever and said she had a general feeling of poor health all Tuesday (ok she's 14, she said icky). Today just low energy. · Healthcare visit (other): Car visit. Doc came to car for checkup and PCR

MedDRA releases: 2024-11 · check-in free text available
2022-01-19
Report sent to call center — 6 months, dose 2, dependent
Be unable to do their normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-20
Call 1 — Left Voicemail
2022-07-22
Survey response — 12 months, dose 2, dependent
MedDRA: COVID-19, Fatigue, Oropharyngeal pain — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: (b)(6), got Covid about a month ago - all five members of the family got it. (b)(6), received her third vaccine dose in April. Her case was mild with a sore throat and some tiredness.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-29	Pfizer-BioNTech	No
2	2021-07-21	Pfizer-BioNTech	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 2, dependent

2021-07-26

Systemic reaction (other): Thoat sore

Release 9 — day 21, dose 2, dependent

2021-08-13

Symptoms: Three days ago very bad headache, didnt want to be awake.

Release 10 — 3 months, dose 2, dependent

2021-10-20

Symptoms: Mya has a cough that isn't much better in ten days and she's periodically vomiting. Rapid strep test negative, waiting for more detailed one. Covid test negative.

Healthcare visit (other): Visited doctor for strep and Covid tests

Release 10 — 6 months, dose 2, dependent

2022-01-19

Symptoms: (b)(6) was with a person who had contact with a known COVID case. We are awaiting PCR results. (b)(6) vomited 1ce Monday night w a low fever and said she had a general feeling of poor health all Tuesday (ok she's 14, she said icky). Today just low energy. cut off by CDC

Healthcare visit (other): Car visit. Doc came to car for checkup and PCR

redacted (b)(6)

Release 12 — 12 months, dose 2, dependent

2022-07-22

Symptoms: (b)(6), got Covid about a month ago - all five members of the family got it. (b)(6), received her third vaccine dose in April. Her case was mild with a sore throat and some tiredness.

redacted (b)(6)

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	Medical counselling	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	SARS-CoV-2 test	·	·	✓
SD	Asthenia	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling abnormal	·	·	✓
SD	Headache	✓	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vomiting	·	·	✓
SRO	Oropharyngeal pain	✓	·	✓

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