U4W-40129-43801
2 vaccinations
4 coded responses
26 check-ins
4 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 672 / KS
- Registered
- 2022-01-04
- Relationship
- Child or adolescent in my care
- Guardian
- 272-10257-34774
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-01-04
Registered in v-safe
-
2022-01-04
Dose 1 — Pfizer-BioNTech
-
2022-01-04
Health check-in — day 0, dose 1, dependentFeeling: Good · Site: Pain, Itching · NoneAdult check-in
- 2022-01-06
- 2022-01-07
- 2022-01-08
- 2022-01-10
-
2022-01-18
Survey response — day 14, dose 1, dependentMedDRA: Abdominal pain upper, Headache — Feeling: GoodFree text: Stomach ache, headacheMedDRA releases: 2024-11 · check-in free text available
-
2022-01-25
Survey response — day 21, dose 1, dependentMedDRA: Exposure to SARS-CoV-2 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: High risk household contact to covid 19. Monitoring for symptoms and unable to test due to lack of testing kits and parent isolation.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-02
Survey response — day 28, dose 1, dependentMedDRA: Fatigue, Pyrexia, SARS-CoV-2 test negative, Vomiting — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Vomiting, fatigue, fever, negative covid testMedDRA releases: 2024-11 · check-in free text available
-
2022-02-08
Survey response — day 35, dose 1, dependentMedDRA: Illness, Nausea — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Continued nausea and recovering from illnessMedDRA releases: 2024-11 · check-in free text available
- 2022-02-15
- 2022-04-05
- 2022-07-05
-
2022-07-06
Dose 2 — Pfizer-BioNTech
-
2022-07-07
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-07-08
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Fatigue or tirednessAdult check-in
- 2022-07-09
- 2022-07-10
- 2022-07-11
- 2022-07-12
- 2022-07-13
- 2022-07-20
- 2022-07-29
- 2022-08-03
- 2022-08-10
- 2022-08-17
- 2022-10-05
- 2023-01-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-01-04 | Pfizer-BioNTech | No |
| 2 | 2022-07-06 | Pfizer-BioNTech | No |
Free text
Release 10 — day 14, dose 1, dependent
Symptoms: Stomach ache, headache
Release 11 — day 21, dose 1, dependent
Symptoms: High risk household contact to covid 19. Monitoring for symptoms and unable to test due to lack of testing kits and parent isolation.
Release 11 — day 28, dose 1, dependent
Symptoms: Vomiting, fatigue, fever, negative covid test
Release 11 — day 35, dose 1, dependent
Symptoms: Continued nausea and recovering from illness
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 | Abdominal pain upper | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Illness | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release