UPL-28634-98520
2 vaccinations
2 coded responses
11 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 913 / CA
- Registered
- 2021-12-12
- Relationship
- Child or adolescent in my care
- Guardian
- 7WS-29585-23909
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-19
Dose 1 — Pfizer-BioNTech
-
2021-12-10
Dose 2 — Pfizer-BioNTech
-
2021-12-12
Registered in v-safe
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-16
- 2021-12-18
- 2021-12-24
- 2022-01-01
- 2022-01-16
-
2022-03-11
Survey response — 3 months, dose 2, dependentMedDRA: Cough, Headache, Oropharyngeal pain — Feeling: Good · Be unable to do their normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: coughing, headache, sore throatMedDRA releases: 2024-11 · check-in free text available
-
2022-03-11
Report sent to call center — 3 months, dose 2, dependentBe unable to do their normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-03-14
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-06-11
-
2022-12-12
Survey response — 12 months, dose 2, dependentMedDRA: Cough — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: coughingMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-19 | Pfizer-BioNTech | No |
| 2 | 2021-12-10 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-03-11 | Successful 2022-03-14 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 11 — 3 months, dose 2, dependent
Symptoms: coughing, headache, sore throat
Release 12 — 12 months, dose 2, dependent
Symptoms: coughing
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 | Headache | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release