4AK-17237-20552

3 vaccinations 10 coded responses 36 check-ins 6 free-text entries 2 call cases

Sex: Male
Age at first dose: 0-4
ZIP prefix: 940 / CA
Registered: 2022-06-24

Relationship: Child or adolescent in my care
Guardian: XG5-28617-20454
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2022-06-24
Registered in v-safe
2022-10-03
Dose 1 — Moderna
2022-10-04
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · Sleepiness, Loss of appetite

Under 3 check-in
2022-10-05
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · None

Under 3 check-in
2022-10-06
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · None

Under 3 check-in
2022-10-07
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · None

Under 3 check-in
2022-10-08
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · None

Under 3 check-in
2022-10-09
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · None

Under 3 check-in
2022-10-10
Health check-in — day 7, dose 1, under 3
Feeling: Good · None

Under 3 check-in
2022-10-17
Health check-in — day 14, dose 1, under 3
Feeling: Good

Under 3 check-in
2022-10-24
Health check-in — day 21, dose 1, under 3
Feeling: Good

Under 3 check-in
2022-10-31
Dose 2 — Moderna
2022-10-31
Health check-in — day 0, dose 2, under 3
Feeling: Good · Site: Pain · Fever · Sleepiness

Under 3 check-in
2022-11-01
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · Sleepiness

Under 3 check-in
2022-11-02
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · None

Under 3 check-in
2022-11-03
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · None

Under 3 check-in
2022-11-04
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · None

Under 3 check-in
2022-11-05
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Fair · Fever · Sleepiness · Be unable to do your normal daily activities

Under 3 check-in
2022-11-06
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · Irritability/crying

Under 3 check-in
2022-11-07
Survey response — day 7, dose 2, under 3
MedDRA: Respiratory tract congestion — Feeling: Fair

Free text: Congestion.

MedDRA releases: 2024-11 · check-in free text available
2022-11-14
Survey response — day 14, dose 2, under 3
MedDRA: Cough — Feeling: Good

Free text: Significant cough.

MedDRA releases: 2024-11 · check-in free text available
2022-11-21
Survey response — day 21, dose 2, under 3
MedDRA: COVID-19, Respiratory tract congestion — Feeling: Good

Free text: He has severe congestion, but is COVID -

MedDRA releases: 2024-11 · check-in free text available
2022-11-28
Survey response — day 28, dose 2, under 3
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair

Free text: Congestion and a cough.

MedDRA releases: 2024-11 · check-in free text available
2022-12-05
Survey response — day 35, dose 2, under 3
MedDRA: Pyrexia, Respiratory tract congestion — Feeling: Fair

Free text: Congestion and a low grade fever

MedDRA releases: 2024-11 · check-in free text available
2022-12-12
Survey response — day 42, dose 2, under 3
MedDRA: Cough, Insomnia, Rhinorrhoea — Feeling: Fair

Free text: He has a cough, runny nose, difficulty sleeping.

MedDRA releases: 2024-11 · check-in free text available
2023-01-28
Dose 3 — Moderna
2023-01-28
Health check-in — day 0, dose 3, under 3
Feeling: Good · Sleepiness

Under 3 check-in
2023-01-29
Health check-in — days 1–6 daily, dose 3, under 3
Feeling: Good · Sleepiness

Under 3 check-in
2023-01-30
Health check-in — days 1–6 daily, dose 3, under 3
Feeling: Good · None

Under 3 check-in
2023-01-31
Health check-in — days 1–6 daily, dose 3, under 3
Feeling: Good · None

Under 3 check-in
2023-02-01
Health check-in — days 1–6 daily, dose 3, under 3
Feeling: Good · Irritability/crying

Under 3 check-in
2023-02-02
Health check-in — days 1–6 daily, dose 3, under 3
Feeling: Good · None

Under 3 check-in
2023-02-03
Health check-in — days 1–6 daily, dose 3, under 3
Feeling: Good · None

Under 3 check-in
2023-02-04
Health check-in — day 7, dose 3, under 3
Feeling: Good · None

Under 3 check-in
2023-02-11
Survey response — day 14, dose 3, under 3
MedDRA: Cough, Rhinorrhoea — Feeling: Good

MedDRA releases: 2024-11
2023-02-18
Health check-in — day 21, dose 3, under 3
Feeling: Good

Under 3 check-in
2023-02-27
Survey response — day 28, dose 3, under 3
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair

MedDRA releases: 2024-11
2023-03-04
Health check-in — day 35, dose 3, under 3
Feeling: Good

Under 3 check-in
2023-03-11
Survey response — day 42, dose 3, under 3
MedDRA: Croup infectious — 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 professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-03-11
Report sent to call center — day 42, dose 3, under 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-03-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-29
Survey response — 3 months, dose 3, under 3
MedDRA: Nasopharyngitis — 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 professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-04-29
Report sent to call center — 3 months, dose 3, under 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-05-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2022-10-03	Moderna	No
2	2022-10-31	Moderna	No
3	2023-01-28	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2023-03-11	Successful 2023-03-13	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-29	Successful 2023-05-01	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 12 (Under 3) — day 7, dose 2, under 3

2022-11-07

Systemic reaction (other): Congestion.

Release 12 (Under 3) — day 14, dose 2, under 3

2022-11-14

Symptoms: Significant cough.

Release 12 (Under 3) — day 21, dose 2, under 3

2022-11-21

Symptoms: He has severe congestion, but is COVID -

Release 12 (Under 3) — day 28, dose 2, under 3

2022-11-28

Symptoms: Congestion and a cough.

Release 12 (Under 3) — day 35, dose 2, under 3

2022-12-05

Symptoms: Congestion and a low grade fever

Release 12 (Under 3) — day 42, dose 2, under 3

2022-12-12

Symptoms: He has a cough, runny nose, difficulty sleeping.

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	COVID-19	·	·	✓
SD	Croup infectious	·	·	✓
SD	Insomnia	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Respiratory tract congestion	·	·	✓

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