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82J-32636-63907

3 vaccinations 5 coded responses 39 check-ins 5 free-text entries 2 call cases
Sex
Male
Age at first dose
0-4
ZIP prefix
662 / KS
Registered
2022-06-28
Relationship
Child or adolescent in my care
Guardian
W76-79819-31134
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2022-06-28
    Registered in v-safe
  2. 2022-06-28
    Dose 1 — Moderna
  3. 2022-06-28
    Health check-in — day 0, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  4. 2022-06-29
    Survey response — days 1–6 daily, dose 1, under 3
    MedDRA: Nasal congestion, SARS-CoV-2 test positive — Feeling: Fair · Fever · Be unable to work or attend school
    Free text: Nasal congestion, tested positive for COVID 6/29/22
    MedDRA releases: 2024-11 · check-in free text available
  5. 2022-06-30
    Survey response — days 1–6 daily, dose 1, under 3
    MedDRA: SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school
    Free text: Positive COVID test 6/29
    MedDRA releases: 2024-11 · check-in free text available
  6. 2022-07-01
    Survey response — days 1–6 daily, dose 1, under 3
    MedDRA: SARS-CoV-2 test positive — Feeling: Good · Fever · Be unable to work or attend school
    Free text: Positive COVID test 6/29
    MedDRA releases: 2024-11 · check-in free text available
  7. 2022-07-02
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  8. 2022-07-03
    Survey response — days 1–6 daily, dose 1, under 3
    MedDRA: Ear infection — Feeling: Fair · Fever · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Ear infection
    MedDRA releases: 2024-11 · check-in free text available
  9. 2022-07-03
    Report sent to call center — days 1–6 daily, dose 1, under 3
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  10. 2022-07-04
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  11. 2022-07-05
    Health check-in — day 7, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  12. 2022-07-05
  13. 2022-07-05
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  14. 2022-07-12
    Health check-in — day 14, dose 1, under 3
    Feeling: Good
    Under 3 check-in
  15. 2022-07-19
    Health check-in — day 21, dose 1, under 3
    Feeling: Good
    Under 3 check-in
  16. 2022-07-26
    Survey response — day 28, dose 1, under 3
    MedDRA: Ear infection, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Another ear infection. He's had chronic ear infections that started months before his COVID vaccines.
    MedDRA releases: 2024-11 · check-in free text available
  17. 2022-07-26
    Report sent to call center — day 28, dose 1, under 3
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  18. 2022-07-27
  19. 2022-07-27
  20. 2022-07-27
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  21. 2022-08-02
    Health check-in — day 35, dose 1, under 3
    Feeling: Good
    Under 3 check-in
  22. 2022-08-09
    Health check-in — day 42, dose 1, under 3
    Feeling: Good
    Under 3 check-in
  23. 2022-08-15
    Dose 2 — Moderna
  24. 2022-08-15
    Health check-in — day 0, dose 2, under 3
    Feeling: Good · None
    Under 3 check-in
  25. 2022-08-16
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Good · None
    Under 3 check-in
  26. 2022-08-17
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Good · None
    Under 3 check-in
  27. 2022-08-18
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Good · None
    Under 3 check-in
  28. 2022-08-20
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Good · None
    Under 3 check-in
  29. 2022-08-21
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Good · None
    Under 3 check-in
  30. 2022-08-22
    Health check-in — day 7, dose 2, under 3
    Feeling: Good · None
    Under 3 check-in
  31. 2022-08-29
    Health check-in — day 14, dose 2, under 3
    Feeling: Good
    Under 3 check-in
  32. 2022-09-05
    Health check-in — day 21, dose 2, under 3
    Feeling: Good
    Under 3 check-in
  33. 2022-09-12
    Health check-in — day 28, dose 2, under 3
    Feeling: Good
    Under 3 check-in
  34. 2022-09-19
    Health check-in — day 35, dose 2, under 3
    Feeling: Good
    Under 3 check-in
  35. 2022-09-26
    Health check-in — day 42, dose 2, under 3
    Feeling: Good
    Under 3 check-in
  36. 2022-11-14
    Health check-in — 3 months, dose 2, under 3
    Feeling: Good
    Under 3 check-in
  37. 2023-02-13
    Health check-in — 6 months, dose 2, under 3
    Feeling: Good
    Under 3 check-in
  38. 2023-02-24
    Dose 3 — Moderna
  39. 2023-02-24
    Health check-in — day 0, dose 3, under 3
    Feeling: Good · None
    Under 3 check-in
  40. 2023-02-27
    Health check-in — days 1–6 daily, dose 3, under 3
    Feeling: Good · None
    Under 3 check-in
  41. 2023-02-28
    Health check-in — days 1–6 daily, dose 3, under 3
    Feeling: Good · None
    Under 3 check-in
  42. 2023-03-01
    Health check-in — days 1–6 daily, dose 3, under 3
    Feeling: Good · None
    Under 3 check-in
  43. 2023-03-02
    Health check-in — days 1–6 daily, dose 3, under 3
    Feeling: Good · None
    Under 3 check-in
  44. 2023-03-03
    Health check-in — day 7, dose 3, under 3
    Feeling: Good · None
    Under 3 check-in
  45. 2023-03-10
    Health check-in — day 14, dose 3, under 3
    Feeling: Good
    Under 3 check-in
  46. 2023-03-17
    Health check-in — day 21, dose 3, under 3
    Feeling: Good
    Under 3 check-in
  47. 2023-03-24
    Health check-in — day 28, dose 3, under 3
    Feeling: Good
    Under 3 check-in
  48. 2023-03-31
    Health check-in — day 35, dose 3, under 3
    Feeling: Good
    Under 3 check-in
  49. 2023-04-07
    Health check-in — day 42, dose 3, under 3
    Feeling: Good
    Under 3 check-in
  50. 2023-05-26
    Health check-in — 3 months, dose 3, under 3
    Feeling: Good
    Under 3 check-in

Vaccinations

DoseDateManufacturerCo-administered
12022-06-28Moderna No
22022-08-15Moderna No
32023-02-24Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2022-07-03 Successful
2022-07-05
 Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-26 Successful
2022-07-27
 Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 12 (Under 3) — days 1–6 daily, dose 1, under 3

2022-06-29

Systemic reaction (other): Nasal congestion, tested positive for COVID 6/29/22

2022-06-30

Systemic reaction (other): Positive COVID test 6/29

2022-07-01

Systemic reaction (other): Positive COVID test 6/29

2022-07-03

Systemic reaction (other): Ear infection

Release 12 (Under 3) — day 28, dose 1, under 3

2022-07-26

Symptoms: Another ear infection. He's had chronic ear infections that started months before his COVID vaccines.

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

FieldPreferred term2021-092023-042024-11
SDEar infection · · ✓
SDPre-existing disease · · ✓
SROEar infection · · ✓
SRONasal congestion · · ✓
SROSARS-CoV-2 test positive · · ✓

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

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