CMF-33396-39974
2 vaccinations
2 coded responses
26 check-ins
1 free-text entry
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 786 / TX
- Registered
- 2022-06-22
- Relationship
- Child or adolescent in my care
- Guardian
- P4X-21761-39390
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-22
Registered in v-safe
-
2022-06-22
Dose 1 — Moderna
- 2022-06-22
- 2022-06-23
- 2022-06-24
- 2022-06-25
- 2022-06-26
-
2022-06-27
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Unevaluable event — Feeling: Good · DiarrheaFree text: Honestly, he probably ate too much broccoli yesterdayMedDRA releases: 2024-11 · check-in free text available
- 2022-06-28
- 2022-06-29
- 2022-07-06
- 2022-07-13
- 2022-07-20
- 2022-07-27
- 2022-08-03
-
2022-08-04
Dose 2 — Moderna
- 2022-08-05
- 2022-08-06
- 2022-08-07
- 2022-08-08
- 2022-08-09
- 2022-08-10
- 2022-08-13
- 2022-08-18
- 2022-08-25
- 2022-09-10
- 2022-09-17
- 2022-11-05
-
2023-02-02
Survey response — 6 months, dose 2, dependentMedDRA: COVID-19 — Feeling: Good · 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 consultationMedDRA releases: 2024-11
-
2023-02-02
Report sent to call center — 6 months, dose 2, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2023-02-03
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-22 | Moderna | No |
| 2 | 2022-08-04 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-02-02 | Successful 2023-02-03 |
Participant prefers to complete VAERS report online |
Free text
Release 12 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Honestly, he probably ate too much broccoli yesterday
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 | COVID-19 | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release