Z6W-31729-19502

3 vaccinations 8 coded responses 33 check-ins 8 free-text entries 0 call cases

Sex: Male
Age at first dose: 05-11
ZIP prefix: 441 / OH
Registered: 2021-11-09

Relationship: Child or adolescent in my care
Guardian: PLW-95687-92830
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-11-08
Dose 1 — Pfizer-BioNTech
2021-11-09
Registered in v-safe
2021-11-09
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-11-11
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Redness · Fatigue or tiredness

Adult check-in
2021-11-12
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-13
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-11-15
Health check-in — day 7, dose 1, dependent
Feeling: Good · Fever · None

Adult check-in
2021-11-22
Health check-in — day 14, dose 1, dependent
Feeling: Good

Adult check-in
2021-11-29
Survey response — day 21, dose 1, dependent
MedDRA: Nausea, Pyrexia, SARS-CoV-2 test negative, Vomiting — Feeling: Fair · Be unable to work or attend school

Free text: Persistent Nausea and vomiting with a fever. Tested for Covid and is negative.

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Dose 2 — Pfizer-BioNTech
2021-12-07
Health check-in — day 0, dose 2, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-12-11
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Adverse reaction, Anxiety, Pre-existing disease — Feeling: Good · Fatigue or tiredness

Free text: (b)(6) autistic- both shots have made him overwhelmed and unable to deal with the mild symptoms

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Fair · Fever · Joint pains, Muscle or body aches

Adult check-in
2021-12-13
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-14
Health check-in — day 7, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-21
Health check-in — day 14, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-29
Health check-in — day 21, dose 2, dependent
Feeling: Good

Adult check-in
2022-01-04
Survey response — day 28, dose 2, dependent
MedDRA: Cough, Pyrexia, SARS-CoV-2 test negative, Viral infection — Feeling: Fair · Be unable to work or attend school

Free text: He's caught some virus- he has a fever (101f) some mild cough. 2 negative Covid antigen tests so probably not Covid. He can't go to school only because of the fever.

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Survey response — day 35, dose 2, dependent
MedDRA: Diarrhoea, Gastrointestinal viral infection, Pyrexia, Vomiting — Feeling: Poor · Be unable to work or attend school

Free text: Gi Virus. He's back in school and caught something. Antigen tests are negative. Vomit, diarrhea, 101f temp.

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Health check-in — day 42, dose 2, dependent
Feeling: Good

Adult check-in
2022-03-08
Health check-in — 3 months, dose 2, dependent
Feeling: Good

Adult check-in
2022-06-07
Health check-in — 6 months, dose 2, dependent
Feeling: Good

Adult check-in
2022-06-29
Dose 3 — Pfizer-BioNTech
2022-06-30
Health check-in — days 1–6 daily, dose 3, dependent
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2022-07-01
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Cutaneous symptom, Injection site rash — Feeling: Good · Site: Redness, Itching

Free text: I'm pretty sure this is a skin reaction to the baindaid used based on the shape, but he's developed a rash around the injection site.

MedDRA releases: 2024-11 · check-in free text available
2022-07-03
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Rash — Feeling: Good · Site: Pain, Itching

Free text: Rash from what I assume is the bandaid persists.

MedDRA releases: 2024-11 · check-in free text available
2022-07-05
Survey response — days 1–6 daily, dose 3, dependent
MedDRA: Rash — Feeling: Good · Site: Itching

Free text: Rash from the bandaid is still there.

MedDRA releases: 2024-11 · check-in free text available
2022-07-06
Survey response — day 7, dose 3, dependent
MedDRA: Rash — Feeling: Good

Free text: Still has the bandaid rash, although it's fading.

MedDRA releases: 2024-11 · check-in free text available
2022-07-13
Health check-in — day 14, dose 3, dependent
Feeling: Good

Adult check-in
2022-07-20
Health check-in — day 21, dose 3, dependent
Feeling: Good

Adult check-in
2022-07-27
Health check-in — day 28, dose 3, dependent
Feeling: Good

Adult check-in
2022-08-04
Health check-in — day 35, dose 3, dependent
Feeling: Good

Adult check-in
2022-08-11
Health check-in — day 42, dose 3, dependent
Feeling: Good

Adult check-in
2022-09-28
Health check-in — 3 months, dose 3, dependent
Feeling: Good

Adult check-in
2022-12-28
Health check-in — 6 months, dose 3, dependent
Feeling: Good

Adult check-in
2023-06-29
Health check-in — 12 months, dose 3, dependent
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-11-08	Pfizer-BioNTech	No
2	2021-12-07	Pfizer-BioNTech	No
3	2022-06-29	Pfizer-BioNTech	No

Free text

Release 10 — day 21, dose 1, dependent

2021-11-29

Symptoms: Persistent Nausea and vomiting with a fever. Tested for Covid and is negative.

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

2021-12-11

Systemic reaction (other): (b)(6) autistic- both shots have made him overwhelmed and unable to deal with the mild symptoms

redacted (b)(6)

Release 10 — day 28, dose 2, dependent

2022-01-04

Symptoms: He's caught some virus- he has a fever (101f) some mild cough. 2 negative Covid antigen tests so probably not Covid. He can't go to school only because of the fever.

Release 10 — day 35, dose 2, dependent

2022-01-11

Symptoms: Gi Virus. He's back in school and caught something. Antigen tests are negative. Vomit, diarrhea, 101f temp.

Release 12 — days 1–6 daily, dose 3, dependent

2022-07-01

Systemic reaction (other): I'm pretty sure this is a skin reaction to the baindaid used based on the shape, but he's developed a rash around the injection site.

2022-07-03

Systemic reaction (other): Rash from what I assume is the bandaid persists.

2022-07-05

Systemic reaction (other): Rash from the bandaid is still there.

Release 12 — day 7, dose 3, dependent

2022-07-06

Systemic reaction (other): Still has the bandaid rash, although it's fading.

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	Diarrhoea	·	·	✓
SD	Gastrointestinal viral infection	·	·	✓
SD	Nausea	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Viral infection	·	·	✓
SD	Vomiting	·	·	✓
SRO	Adverse reaction	·	·	✓
SRO	Anxiety	·	·	✓
SRO	Cutaneous symptom	·	·	✓
SRO	Injection site rash	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Rash	·	·	✓

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