DX7-27864-33293
2 vaccinations
5 coded responses
25 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 05-11
- ZIP prefix
- 688 / NE
- Registered
- 2022-06-29
- Relationship
- Child or adolescent in my care
- Guardian
- 656-31594-08285
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-29
Registered in v-safe
-
2022-06-29
Dose 1 — Moderna
- 2022-06-29
-
2022-07-01
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Itching · NoneAdult check-in
- 2022-07-02
- 2022-07-03
- 2022-07-04
- 2022-07-05
- 2022-07-06
- 2022-07-13
- 2022-07-20
-
2022-07-27
Survey response — day 28, dose 1, dependentMedDRA: Nasopharyngitis — Feeling: FairFree text: ColdMedDRA releases: 2024-11 · check-in free text available
- 2022-08-03
-
2022-08-10
Survey response — day 42, dose 1, dependentMedDRA: Adenotonsillectomy — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Adenoid & tonsillectomy surgeryMedDRA releases: 2024-11 · check-in free text available
-
2022-08-24
Dose 2 — Moderna
-
2022-08-26
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-08-27
- 2022-08-28
- 2022-08-29
- 2022-08-30
- 2022-08-31
- 2022-09-09
-
2022-09-16
Survey response — day 21, dose 2, dependentMedDRA: Cough — Feeling: Fair · Be unable to work or attend schoolFree text: CoughMedDRA releases: 2024-11 · check-in free text available
- 2022-09-21
- 2022-09-28
- 2022-10-05
-
2022-11-23
Survey response — 3 months, dose 2, dependentMedDRA: Ear infection, Tympanic membrane perforation — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Ear infection/ruptured ear drumMedDRA releases: 2024-11 · check-in free text available
-
2022-11-23
Report sent to call center — 3 months, dose 2, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2023-02-22
Survey response — 6 months, dose 2, dependentMedDRA: COVID-19 — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-29 | Moderna | No |
| 2 | 2022-08-24 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-23 | Successful 2022-11-25 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — day 28, dose 1, dependent
Symptoms: Cold
Release 12 — day 42, dose 1, dependent
Symptoms: Adenoid & tonsillectomy surgery
Release 12 — day 21, dose 2, dependent
Symptoms: Cough
Release 12 — 3 months, dose 2, dependent
Symptoms: Ear infection/ruptured ear drum
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 | Adenotonsillectomy | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Tympanic membrane perforation | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release