2NP-11072-03475

2 vaccinations 7 coded responses 23 check-ins 7 free-text entries 3 call cases

Sex: Male
Age at first dose: 12-15
ZIP prefix: 795 / TX
Registered: 2021-08-06

Relationship: Child or adolescent in my care
Guardian: PAY-32813-15840
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-08-06
Registered in v-safe
2021-08-06
Dose 1 — Moderna
2021-08-06
Health check-in — day 0, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-07
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-08
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-09
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-08-10
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-08-11
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-08-12
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-08-13
Health check-in — day 7, dose 1, dependent
Feeling: Good · None

Adult check-in
2021-08-20
Health check-in — day 14, dose 1, dependent
Feeling: Good

Adult check-in
2021-08-28
Survey response — day 21, dose 1, dependent
MedDRA: Body temperature increased, Fatigue, Feeling abnormal, Headache, Hypersensitivity, Pre-existing disease, Self-medication, Sneezing — Feeling: Poor · Be unable to do their normal daily activities

Free text: Sneezing, headache, tired, and juat feels bad. Allergy kid and rag weed is high so he took benedryl with his allergy asthma meds. Has 99 temp not like him but 97 is his norm he was EXPOSED and i was told today his best friend has a rapid pisitive to

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-03
Survey response — day 28, dose 1, dependent
MedDRA: Cough, Dyspnoea, Headache — Feeling: Poor · Be unable to work or attend school

Free text: Cough headache has needed nebulizwr2nd test done Waiting until next week for vaccine since he feels bad.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-09
Dose 2 — Moderna
2021-09-10
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do their normal daily activities

Adult check-in
2021-09-11
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · Site: Pain · None

Adult check-in
2021-09-12
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-09-13
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Asthma, Chest pain, Emergency care, Inflammation, Pre-existing disease — Feeling: Poor · Be unable to work or attend school, Be unable to do their normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Chest pain. ER. Said chest wall inlfammation from asthma flare week ago

MedDRA releases: 2024-11 · check-in free text available
2021-09-13
Report sent to call center — days 1–6 daily, dose 2, dependent
Be unable to work or attend school · Be unable to do their normal daily activities · Get care from a doctor or other healthcare p

1 call case(s)
2021-09-14
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Chest pain, Painful respiration, Unevaluable event — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do their normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): Chest pain when inhales. · Healthcare visit (other): Dr again tomorrow and drive up testing

MedDRA releases: 2024-11 · check-in free text available
2021-09-14
Report sent to call center — days 1–6 daily, dose 2, dependent
Be unable to work or attend school · Be unable to do their normal daily activities · Get care from a doctor or other healthcare p

1 call case(s)
2021-09-15
Survey response — days 1–6 daily, dose 2, dependent
MedDRA: Chest pain, Medical counselling, Oropharyngeal pain — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to work or attend school, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Sore throat chest sore · Healthcare visit (other): Drive up with pcp. No covid done becausr he had shot second recentky. Strep neg is supposed return school tomorrow

MedDRA releases: 2024-11 · check-in free text available
2021-09-15
Report sent to call center — days 1–6 daily, dose 2, dependent
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-15
Call 1 — Left Voicemail
2021-09-16
Health check-in — day 7, dose 2, dependent
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-09-17
Call 1 — Left Voicemail
2021-09-25
Survey response — day 14, dose 2, dependent
MedDRA: Cough, Fatigue, Feeling abnormal, Pre-existing disease — Feeling: Fair

Free text: Cough back after round if sterouds done in a weekFeels bad. Tired wirse than normal alkergies

MedDRA releases: 2024-11 · check-in free text available
2021-10-02
Health check-in — day 21, dose 2, dependent
Feeling: Fair

Adult check-in
2021-10-07
Survey response — day 28, dose 2, dependent
MedDRA: Gastroenteritis viral — Feeling: Good · Be unable to work or attend school

Free text: Had a stomach bug

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Health check-in — day 35, dose 2, dependent
Feeling: Good

Adult check-in
2021-12-12
Health check-in — 3 months, dose 2, dependent
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-08-06	Moderna	No
2	2021-09-09	Moderna	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 9 — day 21, dose 1, dependent

2021-08-28

Symptoms: Sneezing, headache, tired, and juat feels bad. Allergy kid and rag weed is high so he took benedryl with his allergy asthma meds. Has 99 temp not like him but 97 is his norm he was EXPOSED and i was told today his best friend has a rapid pisitive to cut off by CDC

Release 9 — day 28, dose 1, dependent

2021-09-03

Symptoms: Cough headache has needed nebulizwr2nd test done Waiting until next week for vaccine since he feels bad.

Release 9 — days 1–6 daily, dose 2, dependent

2021-09-13

Systemic reaction (other): Chest pain. ER. Said chest wall inlfammation from asthma flare week ago

2021-09-14

Systemic reaction (other): Chest pain when inhales.

Healthcare visit (other): Dr again tomorrow and drive up testing

2021-09-15

Systemic reaction (other): Sore throat chest sore

Healthcare visit (other): Drive up with pcp. No covid done becausr he had shot second recentky. Strep neg is supposed return school tomorrow

Release 9 — day 14, dose 2, dependent

2021-09-25

Symptoms: Cough back after round if sterouds done in a weekFeels bad. Tired wirse than normal alkergies

Release 10 — day 28, dose 2, dependent

2021-10-07

Symptoms: Had a stomach bug

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
HCVO	Medical counselling	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Body temperature increased	✓	·	✓
SD	Cough	✓	·	✓
SD	Dyspnoea	✓	·	✓
SD	Fatigue	✓	·	✓
SD	Feeling abnormal	✓	·	✓
SD	Gastroenteritis viral	·	·	✓
SD	Headache	✓	·	✓
SD	Hypersensitivity	✓	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Self-medication	✓	·	✓
SD	Sneezing	✓	·	✓
SRO	Asthma	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Emergency care	·	·	✓
SRO	Inflammation	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Painful respiration	·	·	✓
SRO	Pre-existing disease	·	·	✓

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