CVM-26133-42874
2 vaccinations
10 coded responses
19 check-ins
9 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 805 / CO
- Registered
- 2022-06-21
- Relationship
- Child or adolescent in my care
- Guardian
- GBC-19506-43733
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-21
Registered in v-safe
-
2022-06-23
Dose 1 — Moderna
- 2022-07-01
- 2022-07-07
- 2022-07-14
- 2022-07-21
- 2022-07-29
-
2022-08-04
Dose 2 — Moderna
-
2022-08-04
Survey response — day 0, dose 2, dependentMedDRA: Emotional distress — Feeling: Fair · Site: PainFree text: Extreme emotionalityMedDRA releases: 2024-11 · check-in free text available
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2022-08-05
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Redness · NoneAdult check-in
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2022-08-06
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Acne — Feeling: Good · Site: PainFree text: A single pimple type bump on forearmMedDRA releases: 2024-11 · check-in free text available
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2022-08-07
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Acne — Feeling: Good · Site: PainFree text: Pimple type bump on forearm.MedDRA releases: 2024-11 · check-in free text available
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2022-08-08
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Acne — Feeling: GoodFree text: Pimple like spot on forearmMedDRA releases: 2024-11 · check-in free text available
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2022-08-09
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Emotional disorder — Feeling: Good · Be unable to do your normal daily activitiesFree text: Highly emotionalMedDRA releases: 2024-11 · check-in free text available
- 2022-08-12
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2022-08-18
Survey response — day 14, dose 2, dependentMedDRA: Rash erythematous — Feeling: GoodFree text: May not be related at all but two red bumps appeared on his temple and forehead two days ago. They do se to be slowly improving.MedDRA releases: 2024-11 · check-in free text available
- 2022-08-25
- 2022-09-01
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2022-09-08
Survey response — day 35, dose 2, dependentMedDRA: Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activitiesFree text: Very runny nose started one week ago. Tested several times. Not COVID.MedDRA releases: 2024-11 · check-in free text available
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2022-09-17
Survey response — day 42, dose 2, dependentMedDRA: Body temperature increased, Nasopharyngitis, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Likely a cold as he did not test positive on rapid tests. However, he had about one week of a very runny nose. About four or five days after feeling better he had an elevated temperature (compared to his typical baseline temp) of 99. Negative again.MedDRA releases: 2024-11 · check-in free text available
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2022-11-03
Survey response — 3 months, dose 2, dependentMedDRA: Pre-existing disease — Feeling: GoodFree text: A chronic cough that has lasted for almost two months.MedDRA releases: 2024-11 · check-in free text available
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2023-02-02
Survey response — 6 months, dose 2, dependentMedDRA: Croup infectious, Lymphadenopathy, Streptococcal infection — 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 consultation, Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-02-03
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2023-02-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-23 | Moderna | No |
| 2 | 2022-08-04 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 12 — day 0, dose 2, dependent
Systemic reaction (other): Extreme emotionality
Release 12 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): A single pimple type bump on forearm
Systemic reaction (other): Pimple type bump on forearm.
Systemic reaction (other): Pimple like spot on forearm
Systemic reaction (other): Highly emotional
Release 12 — day 14, dose 2, dependent
Symptoms: May not be related at all but two red bumps appeared on his temple and forehead two days ago. They do se to be slowly improving.
Release 12 — day 35, dose 2, dependent
Symptoms: Very runny nose started one week ago. Tested several times. Not COVID.
Release 12 — day 42, dose 2, dependent
Symptoms: Likely a cold as he did not test positive on rapid tests. However, he had about one week of a very runny nose. About four or five days after feeling better he had an elevated temperature (compared to his typical baseline temp) of 99. Negative again. cut off by CDC
Release 12 — 3 months, dose 2, dependent
Symptoms: A chronic cough that has lasted for almost two months.
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 | Croup infectious | · | · | ✓ |
| SD | Lymphadenopathy | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rash erythematous | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Streptococcal infection | · | · | ✓ |
| SRO | Acne | · | · | ✓ |
| SRO | Emotional disorder | · | · | ✓ |
| SRO | Emotional distress | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release