F5M-27732-47589
3 vaccinations
3 coded responses
35 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 930 / CA
- Registered
- 2022-06-22
- Relationship
- Child or adolescent in my care
- Guardian
- 375-20314-22665
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-22
Registered in v-safe
-
2022-06-23
Dose 1 — Moderna
- 2022-06-23
-
2022-06-24
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-06-25
- 2022-06-26
- 2022-06-27
- 2022-06-28
- 2022-06-30
- 2022-07-07
- 2022-07-16
- 2022-07-21
-
2022-07-25
Dose 2 — Moderna
- 2022-07-25
-
2022-07-26
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-07-28
- 2022-07-30
- 2022-07-31
- 2022-08-01
- 2022-08-08
- 2022-08-15
- 2022-08-24
- 2022-08-29
- 2022-09-05
-
2022-10-24
Survey response — 3 months, dose 2, dependentMedDRA: Conjunctivitis, Cough, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Pink eye and persistent cough (negative COVID pcr)MedDRA releases: 2024-11 · check-in free text available
-
2022-10-24
Report sent to call center — 3 months, dose 2, dependentBe unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-10-26
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-28
Dose 3 — Pfizer-BioNTech
-
2022-10-29
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-10-30
- 2022-10-31
- 2022-11-02
- 2022-11-03
- 2022-11-06
-
2022-11-12
Survey response — day 14, dose 3, dependentMedDRA: Cough, Gastroenteritis viral, SARS-CoV-2 test negative, Vomiting — Feeling: Good · Be unable to work or attend schoolFree text: Stomach flu with vomiting. Persistent cough, COVID negative.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-20
- 2022-11-25
- 2022-12-02
- 2022-12-09
-
2023-01-27
Survey response — 3 months, dose 3, dependentMedDRA: COVID-19 — Feeling: Good · Be unable to work or attend schoolMedDRA releases: 2024-11
- 2023-04-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-23 | Moderna | No |
| 2 | 2022-07-25 | Moderna | No |
| 3 | 2022-10-28 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-24 | Successful 2022-10-26 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — 3 months, dose 2, dependent
Symptoms: Pink eye and persistent cough (negative COVID pcr)
Release 12 — day 14, dose 3, dependent
Symptoms: Stomach flu with vomiting. Persistent cough, COVID negative.
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 | Conjunctivitis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Gastroenteritis viral | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release