6PN-27867-15698
2 vaccinations
6 coded responses
21 check-ins
6 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 778 / TX
- Registered
- 2022-06-24
- Relationship
- Child or adolescent in my care
- Guardian
- ZJS-12392-82257
- Race
- Other
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-22
Dose 1 — Moderna
-
2022-06-24
Registered in v-safe
- 2022-06-24
-
2022-06-25
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Fair · Sleepiness, Irritability/cryingUnder 3 check-in
-
2022-06-26
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Fair · Sleepiness, Irritability/cryingUnder 3 check-in
-
2022-06-27
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Fair · Sleepiness, Irritability/cryingUnder 3 check-in
-
2022-06-29
Health check-in — day 7, dose 1, under 3Feeling: Fair · Sleepiness, Irritability/crying, Loss of appetite, DiarrheaUnder 3 check-in
-
2022-07-11
Survey response — day 14, dose 1, under 3MedDRA: Diarrhoea, Fatigue, Injection site erythema, Injection site swelling, Irritability, Pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Very red swollen injection site (leg). Fatigue, irritability, pain, diarrhea for about 48 hours starting 8 days after injection.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-13
Survey response — day 21, dose 1, under 3MedDRA: Poor quality sleep — Feeling: FairFree text: Poor sleepMedDRA releases: 2024-11 · check-in free text available
-
2022-07-20
Survey response — day 28, dose 1, under 3MedDRA: Decreased appetite, Irritability — Feeling: FairFree text: Irritable, reduced appetiteMedDRA releases: 2024-11 · check-in free text available
-
2022-07-27
Dose 2 — Moderna
- 2022-07-27
-
2022-07-28
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Site: Pain, Swelling/hardness · Fever · Sleepiness, Irritability/crying, Loss of appetiteUnder 3 check-in
-
2022-07-29
Survey response — days 1–6 daily, dose 2, under 3MedDRA: Epistaxis — Feeling: Fair · Site: Pain, Swelling/hardness · Sleepiness, Irritability/cryingFree text: NosebleedMedDRA releases: 2024-11 · check-in free text available
- 2022-07-30
-
2022-07-31
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Irritability/cryingUnder 3 check-in
-
2022-08-01
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Sleepiness, Irritability/crying, DiarrheaUnder 3 check-in
- 2022-08-02
-
2022-08-03
Health check-in — day 7, dose 2, under 3Feeling: Fair · Irritability/crying, DiarrheaUnder 3 check-in
- 2022-08-10
- 2022-08-25
-
2022-08-31
Survey response — day 35, dose 2, under 3MedDRA: Body temperature increased, Cough, Irritability, Oropharyngeal pain, Rhinorrhoea, Somnolence — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Viral symptoms (sore throat, runny nose, cough, sleepiness, irritability, mildly elevated temp (99F)MedDRA releases: 2024-11 · check-in free text available
- 2022-09-09
-
2022-10-26
Survey response — 3 months, dose 2, under 3MedDRA: Ear infection, Respiratory syncytial virus infection — Feeling: Poor · 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 visitFree text: Rsv, ear infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-10-26
Report sent to call center — 3 months, dose 2, under 3Be 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 · 1 call case(s)
- 2022-10-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-22 | Moderna | No |
| 2 | 2022-07-27 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-26 | Unsuccessful |
Free text
Release 12 (Under 3) — day 14, dose 1, under 3
Symptoms: Very red swollen injection site (leg). Fatigue, irritability, pain, diarrhea for about 48 hours starting 8 days after injection.
Release 12 (Under 3) — day 21, dose 1, under 3
Symptoms: Poor sleep
Release 12 (Under 3) — day 28, dose 1, under 3
Symptoms: Irritable, reduced appetite
Release 12 (Under 3) — days 1–6 daily, dose 2, under 3
Systemic reaction (other): Nosebleed
Release 12 (Under 3) — day 35, dose 2, under 3
Symptoms: Viral symptoms (sore throat, runny nose, cough, sleepiness, irritability, mildly elevated temp (99F)
Release 12 (Under 3) — 3 months, dose 2, under 3
Symptoms: Rsv, ear infection
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 | Body temperature increased | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Decreased appetite | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Injection site erythema | · | · | ✓ |
| SD | Injection site swelling | · | · | ✓ |
| SD | Irritability | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Poor quality sleep | · | · | ✓ |
| SD | Respiratory syncytial virus infection | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Somnolence | · | · | ✓ |
| SRO | Epistaxis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release