RUN-20979-37697
4 vaccinations
13 coded responses
35 check-ins
13 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 018 / MA
- Registered
- 2021-11-07
- Relationship
- Child or adolescent in my care
- Guardian
- R83-14404-83363
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-06
Dose 1 — Pfizer-BioNTech
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2021-11-07
Registered in v-safe
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2021-11-07
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Fatigue or tirednessAdult check-in
-
2021-11-08
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Fatigue or tirednessAdult check-in
-
2021-11-09
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Fatigue or tirednessFree text: (b)(6) is diagnosed with PANS/PANDAS and we're noticing a re-emerging of some symptoms that have been mostly dormant with treatment.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-11
- 2021-11-12
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2021-11-14
Survey response — day 7, dose 1, dependentMedDRA: Aggression, Anxiety, Condition aggravated, Pre-existing disease — Feeling: Good · Fatigue or tirednessFree text: Behavioral (anxiety and aggression) challenges consistent with a PANS/PANDAS flarewhich we knew to expect from the vaccination per pediatrician.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-20
Survey response — day 14, dose 1, dependentMedDRA: Condition aggravated, Pre-existing disease — Feeling: GoodFree text: (b)(6) is definitely in a PANS/PANDAS (autoimmune basil ganglia encephalitis) flare right now, despite daily treatment with antibiotics and anti-inflammatories; the flare started as a result of the vaccination and has worsened. Pedi anticipated this.MedDRA releases: 2024-11 · check-in free text available
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2021-11-27
Dose 2 — Pfizer-BioNTech
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2021-11-28
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Affect lability, Aggression, Defiant behaviour, Irritability — Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessFree text: Emotional volatility and more than usual grumpiness/aggression/defianceMedDRA releases: 2024-11 · check-in free text available
-
2021-11-29
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-12-01
- 2021-12-02
- 2021-12-03
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2021-12-04
Survey response — day 7, dose 2, dependentMedDRA: Condition aggravated, Insomnia, Irritability, Nightmare, Pre-existing disease, Psychomotor hyperactivity, Sensory processing disorder, Sleep deficit — Feeling: Fair · Fatigue or tiredness, Abdominal painFree text: Insomnia for the past few nights and more nightmares and grumpiness than usual, more "wired" hyperactivity and sensory-seeking (heightened ADHD sxs) possibly related to recent reduced sleepMedDRA releases: 2024-11 · check-in free text available
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2021-12-12
Survey response — day 14, dose 2, dependentMedDRA: Fatigue, Medical counselling, Office visit, Oral discomfort, Pyrexia, SARS-CoV-2 test — Feeling: Fair · Be unable to work or attend schoolFree text: "Burning mouth" for a couple of days (tooth coming in? but was enough to send him to the nurse's office and then for a COVID test due to a fever the nurse claimed but then wasn't found at urgent care visit one hour later); additional fatigueMedDRA releases: 2024-11 · check-in free text available
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2021-12-18
Survey response — day 21, dose 2, dependentMedDRA: Abdominal pain, Abdominal pain upper — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Complaining of stomach ache every day this week (7 days). Has gone to school nurse every day this week, says it hurts every time he eats and at random times throughout the day. Will be calling his pedi on Monday.MedDRA releases: 2024-11 · check-in free text available
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2021-12-26
Survey response — day 28, dose 2, dependentMedDRA: Affect lability, Stress, Toothache — Feeling: GoodFree text: Tooth pain with no apparent cause, emotional lability is higher than usual but may be related to holiday stressorsMedDRA releases: 2024-11 · check-in free text available
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2022-01-01
Survey response — day 35, dose 2, dependentMedDRA: Dental cyst, Office visit, Toothache — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professionalFree text: Symptoms: Worsening tooth ache, which has now been evaluated by a dentist and oral surgeon and is the result of a cyst eroding a baby tooth root as his adjacent adult molar is moving in. Surgery to remove the eroding baby tooth is scheduled. · Healthcare visit (other): In-person visit to pedi dentist as well as oral surgeonMedDRA releases: 2024-11 · check-in free text available
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2022-01-01
Report sent to call center — day 35, dose 2, dependentBe unable to work or attend school · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-01-05
-
2022-01-05
Callback requested for04:15PM ET
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2022-01-05
Call successfulCompleted over the phone
- 2022-01-08
- 2022-02-26
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2022-05-21
Dose 3 — Pfizer-BioNTech
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2022-05-28
Survey response — day 7, dose 3, dependentMedDRA: Condition aggravated, Inflammation, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesFree text: Emotional/behavioral symptoms of his PANDAS/PANS diagnosis have flared since he got his third shot last week. Autoimmune encephalitis symptoms likely due to inflammation response to the shot. At this point, we've come to expect a rough week post-shotMedDRA releases: 2024-11 · check-in free text available
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2022-06-06
Survey response — day 14, dose 3, dependentMedDRA: Condition aggravated, Cough, Immune system disorder, Medical counselling, Nasopharyngitis, Oropharyngeal pain, Pre-existing disease, Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Common cold symptoms w/congestion, runny nose, cough and sore throat, less likely related to the vaccination and most likely related to his under functioning immune system post-various public outings we've taken him on. PANDAS flare also continues. · Healthcare visit (other): Phone consultation with his PANS/PANDAS-specialized pediatrician for PANDAS flareMedDRA releases: 2024-11 · check-in free text available
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2022-06-06
Report sent to call center — day 14, dose 3, dependentBe unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-06-08
- 2022-06-12
- 2022-06-13
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2022-06-21
Survey response — day 28, dose 3, dependentMedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesFree text: Most severe PANS/PANDAS flare we've seen since diagnosis a number of years agoMedDRA releases: 2024-11 · check-in free text available
- 2022-06-25
- 2022-07-04
- 2022-08-22
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2022-11-11
Dose 4 — Pfizer-BioNTech
- 2022-11-13
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2022-11-19
Survey response — day 7, dose 4, dependentMedDRA: Insomnia — Feeling: GoodFree text: InsomniaMedDRA releases: 2024-11 · check-in free text available
- 2022-11-25
- 2022-12-02
- 2022-12-10
- 2022-12-16
- 2022-12-24
- 2023-02-11
- 2023-05-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-06 | Pfizer-BioNTech | No |
| 2 | 2021-11-27 | Pfizer-BioNTech | No |
| 3 | 2022-05-21 | Pfizer-BioNTech | No |
| 4 | 2022-11-11 | Pfizer-BioNTech | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
VAERS report filed, before or during a call: 1
Free text
Release 10 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): (b)(6) is diagnosed with PANS/PANDAS and we're noticing a re-emerging of some symptoms that have been mostly dormant with treatment.
redacted (b)(6)
Release 10 — day 7, dose 1, dependent
Systemic reaction (other): Behavioral (anxiety and aggression) challenges consistent with a PANS/PANDAS flarewhich we knew to expect from the vaccination per pediatrician.
Release 10 — day 14, dose 1, dependent
Symptoms: (b)(6) is definitely in a PANS/PANDAS (autoimmune basil ganglia encephalitis) flare right now, despite daily treatment with antibiotics and anti-inflammatories; the flare started as a result of the vaccination and has worsened. Pedi anticipated this. cut off by CDC
redacted (b)(6)
Release 10 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Emotional volatility and more than usual grumpiness/aggression/defiance
Release 10 — day 7, dose 2, dependent
Systemic reaction (other): Insomnia for the past few nights and more nightmares and grumpiness than usual, more "wired" hyperactivity and sensory-seeking (heightened ADHD sxs) possibly related to recent reduced sleep
Release 10 — day 14, dose 2, dependent
Symptoms: "Burning mouth" for a couple of days (tooth coming in? but was enough to send him to the nurse's office and then for a COVID test due to a fever the nurse claimed but then wasn't found at urgent care visit one hour later); additional fatigue
Release 10 — day 21, dose 2, dependent
Symptoms: Complaining of stomach ache every day this week (7 days). Has gone to school nurse every day this week, says it hurts every time he eats and at random times throughout the day. Will be calling his pedi on Monday.
Release 10 — day 28, dose 2, dependent
Symptoms: Tooth pain with no apparent cause, emotional lability is higher than usual but may be related to holiday stressors
Release 10 — day 35, dose 2, dependent
Symptoms: Worsening tooth ache, which has now been evaluated by a dentist and oral surgeon and is the result of a cyst eroding a baby tooth root as his adjacent adult molar is moving in. Surgery to remove the eroding baby tooth is scheduled.
Healthcare visit (other): In-person visit to pedi dentist as well as oral surgeon
Release 11 — day 7, dose 3, dependent
Systemic reaction (other): Emotional/behavioral symptoms of his PANDAS/PANS diagnosis have flared since he got his third shot last week. Autoimmune encephalitis symptoms likely due to inflammation response to the shot. At this point, we've come to expect a rough week post-shot cut off by CDC
Release 11 — day 14, dose 3, dependent
Symptoms: Common cold symptoms w/congestion, runny nose, cough and sore throat, less likely related to the vaccination and most likely related to his under functioning immune system post-various public outings we've taken him on. PANDAS flare also continues. cut off by CDC
Healthcare visit (other): Phone consultation with his PANS/PANDAS-specialized pediatrician for PANDAS flare
Release 12 — day 28, dose 3, dependent
Symptoms: Most severe PANS/PANDAS flare we've seen since diagnosis a number of years ago
Release 12 — day 7, dose 4, dependent
Systemic reaction (other): Insomnia
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 | Condition aggravated | · | · | ✓ |
| HCVO | Medical counselling | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Pre-existing disease | · | · | ✓ |
| SD | Abdominal pain | · | · | ✓ |
| SD | Abdominal pain upper | · | · | ✓ |
| SD | Affect lability | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dental cyst | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Immune system disorder | · | · | ✓ |
| SD | Medical counselling | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oral discomfort | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test | · | · | ✓ |
| SD | Stress | · | · | ✓ |
| SD | Toothache | · | · | ✓ |
| SRO | Affect lability | · | · | ✓ |
| SRO | Aggression | · | · | ✓ |
| SRO | Anxiety | · | · | ✓ |
| SRO | Condition aggravated | · | · | ✓ |
| SRO | Defiant behaviour | · | · | ✓ |
| SRO | Inflammation | · | · | ✓ |
| SRO | Insomnia | · | · | ✓ |
| SRO | Irritability | · | · | ✓ |
| SRO | Nightmare | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Psychomotor hyperactivity | · | · | ✓ |
| SRO | Sensory processing disorder | · | · | ✓ |
| SRO | Sleep deficit | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release