XP8-31100-77927
3 vaccinations
3 coded responses
11 check-ins
3 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 606 / IL
- Registered
- 2021-11-27
- Relationship
- Child or adolescent in my care
- Guardian
- YUZ-31640-66559
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-05
Dose 1 — Pfizer-BioNTech
-
2021-11-26
Dose 2 — Pfizer-BioNTech
-
2021-11-27
Registered in v-safe
-
2021-11-27
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-11-29
- 2021-11-30
- 2021-12-02
-
2021-12-03
Survey response — day 7, dose 2, dependentMedDRA: Eczema, Pre-existing disease — Feeling: Good · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Eczema flareMedDRA releases: 2024-11 · check-in free text available
-
2021-12-03
Report sent to call center — day 7, dose 2, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-12-06
-
2021-12-08
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2021-12-09
-
2021-12-24
Survey response — day 28, dose 2, dependentMedDRA: Nasopharyngitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: ColdMedDRA releases: 2024-11 · check-in free text available
-
2021-12-24
Report sent to call center — day 28, dose 2, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-12-27
Call successfulDoes not wish to fill out VAERS report
- 2022-01-07
- 2022-02-27
-
2022-05-22
Dose 3 — Pfizer-BioNTech
- 2022-05-29
-
2022-06-05
Survey response — day 14, dose 3, dependentMedDRA: Malaise — 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 · Telehealth, virtual health, or email health consultationFree text: Covid sxMedDRA releases: 2024-11 · check-in free text available
-
2022-06-05
Report sent to call center — day 14, dose 3, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-06-06
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-06-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-05 | Pfizer-BioNTech | No |
| 2 | 2021-11-26 | Pfizer-BioNTech | No |
| 3 | 2022-05-22 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-03 | Successful 2021-12-08 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2021-12-24 | Successful 2021-12-27 |
Does not wish to fill out VAERS report |
| 2022-06-05 | Successful 2022-06-06 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 10 — day 7, dose 2, dependent
Systemic reaction (other): Eczema flare
Release 10 — day 28, dose 2, dependent
Symptoms: Cold
Release 11 — day 14, dose 3, dependent
Symptoms: Covid sx
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 | Malaise | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SRO | Eczema | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release