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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

  1. 2021-11-16
    Dose 1 — Pfizer-BioNTech
  2. 2021-11-17
    Registered in v-safe
  3. 2021-11-17
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  4. 2021-11-18
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  5. 2021-11-19
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  6. 2021-11-20
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  7. 2021-11-23
    Health check-in — day 7, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  8. 2021-11-30
    Health check-in — day 14, dose 1, dependent
    Feeling: Good
    Adult check-in
  9. 2021-12-07
    Dose 2 — Pfizer-BioNTech
  10. 2021-12-07
    Health check-in — day 0, dose 2, dependent
    Feeling: Good · None
    Adult check-in
  11. 2021-12-09
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Good · None
    Adult check-in
  12. 2021-12-10
    Survey response — days 1–6 daily, dose 2, dependent
    MedDRA: Axillary pain — Feeling: Fair · Site: Pain
    Free text: Pain is in armpit
    MedDRA releases: 2024-11 · check-in free text available
  13. 2021-12-11
    Survey response — days 1–6 daily, dose 2, dependent
    MedDRA: Axillary pain, Lymph node pain — Feeling: Good · Site: Pain
    Free text: Pain is in armpit/lymph node same arm as injection site
    MedDRA releases: 2024-11 · check-in free text available
  14. 2021-12-12
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Good · None
    Adult check-in
  15. 2021-12-13
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Good · None
    Adult check-in
  16. 2021-12-14
    Health check-in — day 7, dose 2, dependent
    Feeling: Good · None
    Adult check-in
  17. 2021-12-21
    Health check-in — day 14, dose 2, dependent
    Feeling: Good
    Adult check-in
  18. 2021-12-28
    Health check-in — day 21, dose 2, dependent
    Feeling: Good
    Adult check-in
  19. 2022-01-06
    Health check-in — day 28, dose 2, dependent
    Feeling: Good
    Adult check-in
  20. 2022-01-11
    Health check-in — day 35, dose 2, dependent
    Feeling: Good
    Adult check-in
  21. 2022-01-18
    Health check-in — day 42, dose 2, dependent
    Feeling: Good
    Adult check-in
  22. 2022-03-08
  23. 2022-12-09
    Survey response — 12 months, dose 2, dependent
    MedDRA: 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 activities
    Free text: Constant viral sickness/missed school. Stomach and chest pain, leg pain, headaches, bloody noses
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-11-16Pfizer-BioNTech No
22021-12-07Pfizer-BioNTech No

Free text

Release 10 — days 1–6 daily, dose 2, dependent

2021-12-10

Systemic reaction (other): Pain is in armpit

2021-12-11

Systemic reaction (other): Pain is in armpit/lymph node same arm as injection site

Release 12 — 12 months, dose 2, dependent

2022-12-09

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

FieldPreferred term2021-092023-042024-11
SDAbdominal pain upper · · ✓
SDChest pain · · ✓
SDEpistaxis · · ✓
SDLoss of personal independence in daily activities · · ✓
SDPain in extremity · · ✓
SDViral infection · · ✓
SROAxillary pain · · ✓
SROLymph node pain · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release