XAY-15812-29687
2 vaccinations
2 coded responses
8 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 421 / KY
- Registered
- 2022-06-21
- Relationship
- Child or adolescent in my care
- Guardian
- VD5-32519-50337
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-07
Dose 1 — Pfizer-BioNTech
-
2022-06-21
Registered in v-safe
- 2022-06-24
-
2022-06-28
Dose 2 — Pfizer-BioNTech
-
2022-06-30
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Pyrexia — Feeling: GoodFree text: FeverMedDRA releases: 2024-11 · check-in free text available
- 2022-07-03
- 2022-07-04
- 2022-07-21
- 2022-07-26
- 2022-08-02
-
2022-09-27
Survey response — 3 months, dose 2, dependentMedDRA: Cough, Discharge, Headache — 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 · Outpatient clinic or urgent care clinic visitFree text: Cough, headache, drainageMedDRA releases: 2024-11 · check-in free text available
-
2022-09-27
Report sent to call center — 3 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)
-
2022-09-28
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-07 | Pfizer-BioNTech | No |
| 2 | 2022-06-28 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-09-27 | Successful 2022-09-28 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Fever
Release 12 — 3 months, dose 2, dependent
Symptoms: Cough, headache, drainage
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 | Discharge | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release