KLS-20007-06357
2 vaccinations
3 coded responses
17 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 979 / OR
- Registered
- 2022-10-18
- Relationship
- Child or adolescent in my care
- Guardian
- 6VM-30747-38002
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-10-13
Dose 1 — Other-UnknownCo-administered: Flu
-
2022-10-18
Registered in v-safe
-
2022-10-18
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Good · Irritability/crying, Loss of appetiteUnder 3 check-in
- 2022-10-19
- 2022-10-20
-
2022-10-27
Survey response — day 14, dose 1, under 3MedDRA: Balance disorder — Feeling: FairFree text: Could be an inner ear infection, but since the day after vaccination he's had balance issues.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-03
Dose 2 — Other-Unknown
-
2022-11-03
Health check-in — day 0, dose 2, under 3Feeling: Good · Sleepiness, Irritability/cryingUnder 3 check-in
- 2022-11-06
- 2022-11-07
- 2022-11-08
- 2022-11-09
- 2022-11-12
- 2022-11-19
- 2022-11-26
-
2022-12-01
Survey response — day 28, dose 2, under 3MedDRA: Malaise, Pyrexia, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Fever of 105, viral activity on chest xray negative respiratory virus panel. Sick for days followed by full body rash.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-01
Report sent to call center — day 28, dose 2, under 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-12-02
- 2022-12-08
- 2022-12-15
- 2023-02-02
-
2023-05-04
Survey response — 6 months, dose 2, under 3MedDRA: Speech disorder — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-10-13 | Other-Unknown | Flu |
| 2 | 2022-11-03 | Other-Unknown | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-01 | Unsuccessful |
Free text
Release 12 (Under 3) — day 14, dose 1, under 3
Symptoms: Could be an inner ear infection, but since the day after vaccination he's had balance issues.
Release 12 (Under 3) — day 28, dose 2, under 3
Symptoms: Fever of 105, viral activity on chest xray negative respiratory virus panel. Sick for days followed by full body rash.
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 | Balance disorder | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Speech disorder | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release