SM3-43841-97872
2 vaccinations
4 coded responses
21 check-ins
4 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 630 / MO
- Registered
- 2021-11-13
- Relationship
- Child or adolescent in my care
- Guardian
- KMF-42381-94843
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-13
Registered in v-safe
-
2021-11-13
Dose 1 — Pfizer-BioNTech
- 2021-11-13
- 2021-11-14
- 2021-11-15
- 2021-11-16
- 2021-11-19
- 2021-11-20
-
2021-11-27
Survey response — day 14, dose 1, dependentMedDRA: Nasopharyngitis — Feeling: GoodFree text: He has a small cold.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-04
Dose 2 — Pfizer-BioNTech
- 2021-12-04
-
2021-12-05
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-12-07
- 2021-12-08
- 2021-12-10
- 2021-12-11
-
2021-12-18
Survey response — day 14, dose 2, dependentMedDRA: Cough, Nasopharyngitis — Feeling: FairFree text: Cough/ coldMedDRA releases: 2024-11 · check-in free text available
-
2021-12-25
Survey response — day 21, dose 2, dependentMedDRA: Pain, Pyrexia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: He had a fever and body aches for about 24 hours and then fine.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-25
Report sent to call center — day 21, dose 2, dependentGet care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-12-27
- 2022-01-01
-
2022-01-05
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-08
- 2022-01-15
- 2022-03-05
-
2022-06-04
Survey response — 6 months, dose 2, dependentMedDRA: Conjunctivitis, Influenza A virus test positive, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: He had pink eye and then tested positive for ingluenza type A. He tested negative for covid each time.MedDRA releases: 2024-11 · check-in free text available
-
2022-06-04
Report sent to call center — 6 months, dose 2, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-06-06
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-12-04
-
no date
Callback requested for06:00PM ET
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-13 | Pfizer-BioNTech | No |
| 2 | 2021-12-04 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 successful
Free text
Release 10 — day 14, dose 1, dependent
Symptoms: He has a small cold.
Release 10 — day 14, dose 2, dependent
Symptoms: Cough/ cold
Release 10 — day 21, dose 2, dependent
Symptoms: He had a fever and body aches for about 24 hours and then fine.
Release 11 — 6 months, dose 2, dependent
Symptoms: He had pink eye and then tested positive for ingluenza type A. He tested negative for covid each time.
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 | Conjunctivitis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Influenza A virus test positive | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release