HCJ-17738-89533
2 vaccinations
2 coded responses
16 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 804 / CO
- Registered
- 2022-10-27
- Relationship
- Child or adolescent in my care
- Guardian
- RMT-29700-73707
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2022-10-13
Dose 1 — Moderna
-
2022-10-27
Registered in v-safe
- 2022-10-27
-
2022-11-03
Survey response — day 21, dose 1, under 3MedDRA: Cough, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend schoolFree text: Congestion and coughMedDRA releases: 2024-11 · check-in free text available
-
2022-11-10
Dose 2 — Moderna
-
2022-11-11
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Site: Pain · Irritability/cryingUnder 3 check-in
- 2022-11-12
- 2022-11-13
- 2022-11-14
- 2022-11-15
- 2022-11-16
- 2022-11-19
- 2022-11-24
- 2022-12-01
- 2022-12-08
- 2022-12-15
-
2022-12-22
Survey response — day 42, dose 2, under 3MedDRA: Ear infection, Malaise, Pyrexia, Rhinorrhoea — 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 · Outpatient clinic or urgent care clinic visitFree text: He was sick with a fever and runny nose which led to an ear infection. He wasn't tested for covid.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-22
Report sent to call center — day 42, dose 2, under 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-23
-
2022-12-23
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-12-27
- 2023-02-09
- 2023-05-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-10-13 | Moderna | No |
| 2 | 2022-11-10 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-22 | Successful 2022-12-23 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 (Under 3) — day 21, dose 1, under 3
Symptoms: Congestion and cough
Release 12 (Under 3) — day 42, dose 2, under 3
Symptoms: He was sick with a fever and runny nose which led to an ear infection. He wasn't tested for covid.
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 | Cough | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release