Z47-23403-18841
2 vaccinations
5 coded responses
24 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 05-11
- ZIP prefix
- 038 / NH
- Registered
- 2021-11-17
- Relationship
- Child or adolescent in my care
- Guardian
- 9QF-60501-73794
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-11-17
Registered in v-safe
-
2021-11-17
Dose 1 — Pfizer-BioNTech
- 2021-11-17
- 2021-11-18
- 2021-11-20
- 2021-11-21
- 2021-11-22
- 2021-11-23
- 2021-11-24
-
2021-12-01
Survey response — day 14, dose 1, dependentMedDRA: Nasal congestion — Feeling: GoodFree text: Nasal congestionMedDRA releases: 2024-11 · check-in free text available
-
2021-12-08
Dose 2 — Pfizer-BioNTech
- 2021-12-08
- 2021-12-09
- 2021-12-10
- 2021-12-11
- 2021-12-12
- 2021-12-13
- 2021-12-14
- 2021-12-15
- 2021-12-22
- 2021-12-29
- 2022-01-05
-
2022-01-12
Survey response — day 35, dose 2, dependentMedDRA: Exposure to SARS-CoV-2, Rash, Respiratory tract congestion, Sneezing — Feeling: Good · Be unable to work or attend schoolFree text: Sneezing, congestion, rash. 2 family members are Covid positiveMedDRA releases: 2024-11 · check-in free text available
-
2022-01-19
Survey response — day 42, dose 2, dependentMedDRA: Exposure to SARS-CoV-2, Nasal congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend schoolFree text: Nasal congestion and runny nose, brother and mother positive for Covid. She remained antigen test negative. Symposium for 3 days. Now feels greatMedDRA releases: 2024-11 · check-in free text available
-
2022-03-09
Survey response — 3 months, dose 2, dependentMedDRA: Exposure to SARS-CoV-2, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: GoodFree text: Runny nose and mild sore throat in January at the time brother and mother has Covid. Her antigen tests remained negativeMedDRA releases: 2024-11 · check-in free text available
- 2022-06-08
-
2022-12-08
Survey response — 12 months, dose 2, dependentMedDRA: Bacterial tracheitis — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, HospitalizationFree text: Bacterial tracheitis, not related to Covid or the vaccine.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-08
Report sent to call center — 12 months, 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 prOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-12-09
- 2022-12-12
-
2022-12-12
Callback requested for08:00AM ET
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-11-17 | Pfizer-BioNTech | No |
| 2 | 2021-12-08 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-08 | Unsuccessful |
Free text
Release 10 — day 14, dose 1, dependent
Symptoms: Nasal congestion
Release 10 — day 35, dose 2, dependent
Symptoms: Sneezing, congestion, rash. 2 family members are Covid positive
Release 10 — day 42, dose 2, dependent
Symptoms: Nasal congestion and runny nose, brother and mother positive for Covid. She remained antigen test negative. Symposium for 3 days. Now feels great
Release 11 — 3 months, dose 2, dependent
Symptoms: Runny nose and mild sore throat in January at the time brother and mother has Covid. Her antigen tests remained negative
Release 12 — 12 months, dose 2, dependent
Symptoms: Bacterial tracheitis, not related to Covid or the vaccine.
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 | Bacterial tracheitis | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release