XJ3-21330-94628
2 vaccinations
3 coded responses
20 check-ins
3 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 551 / MN
- Registered
- 2021-11-17
- Relationship
- Child or adolescent in my care
- Guardian
- 5BJ-15980-99620
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-16
Dose 1 — Pfizer-BioNTech
-
2021-11-17
Registered in v-safe
- 2021-11-17
- 2021-11-18
- 2021-11-19
- 2021-11-20
- 2021-11-23
- 2021-11-30
-
2021-12-07
Dose 2 — Pfizer-BioNTech
- 2021-12-07
- 2021-12-09
-
2021-12-10
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Axillary pain — Feeling: Fair · Site: PainFree text: Pain is in armpitMedDRA releases: 2024-11 · check-in free text available
-
2021-12-11
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Axillary pain, Lymph node pain — Feeling: Good · Site: PainFree text: Pain is in armpit/lymph node same arm as injection siteMedDRA releases: 2024-11 · check-in free text available
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-21
- 2021-12-28
- 2022-01-06
- 2022-01-11
- 2022-01-18
- 2022-03-08
-
2022-12-09
Survey response — 12 months, dose 2, dependentMedDRA: Abdominal pain upper, Chest pain, Epistaxis, Loss of personal independence in daily activities, Pain in extremity, Viral infection — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Constant viral sickness/missed school. Stomach and chest pain, leg pain, headaches, bloody nosesMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-16 | Pfizer-BioNTech | No |
| 2 | 2021-12-07 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Pain is in armpit
Systemic reaction (other): Pain is in armpit/lymph node same arm as injection site
Release 12 — 12 months, dose 2, dependent
Symptoms: Constant viral sickness/missed school. Stomach and chest pain, leg pain, headaches, bloody noses
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 | Chest pain | · | · | ✓ |
| SD | Epistaxis | · | · | ✓ |
| SD | Loss of personal independence in daily activities | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release