XYC-14407-31603
2 vaccinations
10 coded responses
19 check-ins
10 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 553 / MN
- Registered
- 2021-11-18
- Relationship
- Child or adolescent in my care
- Guardian
- LWX-21972-39422
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-11
Dose 1 — Pfizer-BioNTech
-
2021-11-18
Registered in v-safe
-
2021-11-18
Survey response — 7 day, dose 1, dependentMedDRA: Generalised tonic-clonic seizure — Feeling: GoodMedDRA releases: 2024-11 · check-in answers available
-
2021-11-25
Survey response — 14 day, dose 1, dependentMedDRA: Nasopharyngitis, Seizure — Feeling: Good · Be unable to work or attend schoolMedDRA releases: 2024-11 · check-in answers available
-
2021-12-04
Survey response — 21 day, dose 1, dependentMedDRA: Seizure like phenomena — Feeling: Good · Be unable to do their normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitMedDRA releases: 2024-11 · check-in answers available
-
2021-12-04
Report sent to call center — 21 day, dose 1, dependentBe unable to do their normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2021-12-06
-
2021-12-07
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-12-08
Dose 2 — Pfizer-BioNTech
- 2021-12-08
-
2021-12-09
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · Fever · Fatigue or tirednessAdult check-in
-
2021-12-10
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · NoneAdult check-in
-
2021-12-11
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-17
-
2021-12-22
Survey response — 14 day, dose 2, dependentMedDRA: Gastroenteritis viral — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
-
2021-12-29
Survey response — 21 day, dose 2, dependentMedDRA: Gastroenteritis viral — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
-
2022-01-05
Survey response — 28 day, dose 2, dependentMedDRA: Gastroenteritis viral — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
-
2022-01-12
Survey response — 35 day, dose 2, dependentMedDRA: Gastroenteritis viral — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
-
2022-01-21
Survey response — 42 day, dose 2, dependentMedDRA: Gastroenteritis viral — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11 · check-in answers available
- 2022-03-09
-
2022-06-08
Survey response — 6 month, dose 2, dependentMedDRA: Gastroenteritis viral — Feeling: Fair · Be unable to work or attend schoolMedDRA releases: 2024-11 · check-in answers available
-
2022-12-10
Survey response — 12 month, dose 2, dependentMedDRA: Ear infection, Influenza, Nasopharyngitis, Office visit — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11 · check-in answers available
-
2022-12-10
Report sent to call center — 12 month, 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 pr1 call case(s)
-
2022-12-12
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 | 2021-11-11 | Pfizer-BioNTech | No |
| 2 | 2021-12-08 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-12-04 | Successful 2021-12-07 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-12-10 | Successful 2022-12-12 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 10
Systemic reaction (other): (b)(6) did have what we thought was a tonic-clonic seizure on 11/13.
redacted (b)(6)
Symptoms: (b)(6)had a seizure 2 days after his first dose, and also had a cold.
redacted (b)(6)
Symptoms: He had what we think was a seizure 2 days after his first vaccination. He sees his pediatric neurologist 2 days after his second vaccination dose.
Symptoms: (b)(6)had a stomach bug.
redacted (b)(6)
Symptoms: Stomach bug
Symptoms: Stomach bug not related to vaccination
Symptoms: Stomach bug not related to vaccine
Release 11
Symptoms: Stomach flu not related to vaccine
Symptoms: Stomach flu
Release 12
Symptoms: Influenza A, ear infection, cold. Antibiotics used to treat the ear inflection. He has been vaccinated for the flu.
Healthcare visit (other): Office visit
Free-text releases are not linked to a specific 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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Gastroenteritis viral | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Seizure | · | · | ✓ |
| SD | Seizure like phenomena | · | · | ✓ |
| SRO | Generalised tonic-clonic seizure | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release