4KP-30410-47780
2 vaccinations
4 coded responses
12 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 175 / PA
- Registered
- 2022-07-04
- Relationship
- Child or adolescent in my care
- Guardian
- CCF-11837-72726
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-07-01
Dose 1 — Moderna
-
2022-07-04
Registered in v-safe
-
2022-07-04
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Ear pain — Feeling: FairFree text: Ear acheMedDRA releases: 2024-11 · check-in free text available
-
2022-07-06
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Conjunctivitis, Ear pain, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Systemic reaction (other): Earache conjunctivitis · Healthcare visit (other): Pediatrician's officeMedDRA releases: 2024-11 · check-in free text available
-
2022-07-06
Report sent to call center — days 1–6 daily, dose 1, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-07-07
Call successfulDoes not wish to fill out VAERS report
- 2022-07-08
- 2022-07-17
- 2022-07-22
-
2022-08-01
Dose 2 — Moderna
- 2022-08-01
-
2022-08-02
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Oropharyngeal pain — Feeling: Good · Site: PainFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
-
2022-08-03
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Cough, Rhinorrhoea — Feeling: GoodFree text: Cough runny noseMedDRA releases: 2024-11 · check-in free text available
- 2022-08-06
- 2022-08-08
- 2022-08-15
- 2022-09-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-07-01 | Moderna | No |
| 2 | 2022-08-01 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-07-06 | Successful 2022-07-07 |
Does not wish to fill out VAERS report |
Free text
Release 12 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Ear ache
Systemic reaction (other): Earache conjunctivitis
Healthcare visit (other): Pediatrician's office
Release 12 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Sore throat
Systemic reaction (other): Cough runny nose
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 | Office visit | · | · | ✓ |
| SRO | Conjunctivitis | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Ear pain | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release