YP8-20371-08781
4 vaccinations
9 coded responses
47 check-ins
9 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 916 / CA
- Registered
- 2021-11-06
- Relationship
- Child or adolescent in my care
- Guardian
- A6J-85430-64220
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-06
Registered in v-safe
-
2021-11-06
Dose 1 — Pfizer-BioNTech
- 2021-11-06
-
2021-11-07
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2021-11-09
- 2021-11-11
- 2021-11-12
- 2021-11-15
- 2021-11-20
- 2021-11-27
-
2021-12-04
Dose 2 — Pfizer-BioNTech
- 2021-12-04
- 2021-12-05
- 2021-12-06
- 2021-12-07
- 2021-12-08
- 2021-12-09
- 2021-12-11
- 2021-12-20
-
2021-12-25
Survey response — day 21, dose 2, dependentMedDRA: Pain, Pyrexia, Vomiting — Feeling: Good · Be unable to do your normal daily activitiesFree text: (b)(6) had a fever and body aches for just under 18 hours with a little bit of vomit.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-01
- 2022-01-08
- 2022-01-15
- 2022-03-05
-
2022-05-27
Dose 3 — Pfizer-BioNTech
-
2022-05-28
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Axillary pain — Feeling: Good · Site: Pain · Joint painsFree text: Pain in the underarm area of the arm where he received the shotMedDRA releases: 2024-11 · check-in free text available
-
2022-05-29
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Axillary pain — Feeling: Good · Site: Pain · Muscle or body achesFree text: Underarm pain same side as shot givenMedDRA releases: 2024-11 · check-in free text available
-
2022-05-30
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Axillary pain — Feeling: Good · Site: Pain · Muscle or body achesFree text: Underarm pain on same arm as shotMedDRA releases: 2024-11 · check-in free text available
-
2022-05-31
Survey response — days 1–6 daily, dose 3, dependentMedDRA: Unevaluable event — Feeling: Good · Site: Pain · Muscle or body achesFree text: In the underarm of the arm he got the shotMedDRA releases: 2024-11 · check-in free text available
- 2022-06-01
- 2022-06-02
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-06-24
-
2022-07-03
Survey response — day 35, dose 3, dependentMedDRA: Vomiting — Feeling: GoodFree text: Stomach it with a little bit of vomit. Seems fine now. Must have been something bad he ate.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-08
- 2022-08-28
-
2022-11-27
Survey response — 6 months, dose 3, dependentMedDRA: Cough, Influenza, Nasopharyngitis — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Bad cold followed one week later by a bad flu and nasty cough.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-18
Dose 4 — Moderna
-
2022-12-19
Health check-in — days 1–6 daily, dose 4, dependentFeeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-12-20
Survey response — days 1–6 daily, dose 4, dependentMedDRA: Lymph node pain — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: Lymph nodes at every soreMedDRA releases: 2024-11 · check-in free text available
-
2022-12-21
Survey response — days 1–6 daily, dose 4, dependentMedDRA: Lymph node pain — Feeling: Good · Muscle or body aches, NauseaFree text: Lymph nodes are still soreMedDRA releases: 2024-11 · check-in free text available
- 2022-12-22
- 2022-12-23
- 2022-12-25
- 2023-01-01
- 2023-01-08
- 2023-01-15
- 2023-01-22
- 2023-01-29
- 2023-03-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-06 | Pfizer-BioNTech | No |
| 2 | 2021-12-04 | Pfizer-BioNTech | No |
| 3 | 2022-05-27 | Pfizer-BioNTech | No |
| 4 | 2022-12-18 | Moderna | No |
Free text
Release 10 — day 21, dose 2, dependent
Symptoms: (b)(6) had a fever and body aches for just under 18 hours with a little bit of vomit.
redacted (b)(6)
Release 11 — days 1–6 daily, dose 3, dependent
Systemic reaction (other): Pain in the underarm area of the arm where he received the shot
Systemic reaction (other): Underarm pain same side as shot given
Systemic reaction (other): Underarm pain on same arm as shot
Systemic reaction (other): In the underarm of the arm he got the shot
Release 12 — day 35, dose 3, dependent
Symptoms: Stomach it with a little bit of vomit. Seems fine now. Must have been something bad he ate.
Release 12 — 6 months, dose 3, dependent
Symptoms: Bad cold followed one week later by a bad flu and nasty cough.
Release 12 — days 1–6 daily, dose 4, dependent
Systemic reaction (other): Lymph nodes at every sore
Systemic reaction (other): Lymph nodes are still sore
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 | Influenza | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Axillary pain | · | · | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release