PM4-33675-98562

3 vaccinations 7 coded responses 37 check-ins 4 free-text entries 4 call cases

Sex: Female
Age at first dose: 0-4
ZIP prefix: 210 / MD
Registered: 2022-06-20

Relationship: Child or adolescent in my care
Guardian: WLX-14118-65424
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2022-06-20
Registered in v-safe
2022-06-21
Dose 1 — Moderna
2022-06-21
Health check-in — day 0, dose 1, under 3
Feeling: Good · None

Under 3 check-in
2022-06-22
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Fair · Site: Pain, Redness, Swelling/hardness · Irritability/crying

Under 3 check-in
2022-06-23
Survey response — days 1–6 daily, dose 1, under 3
MedDRA: Sleep terror — Feeling: Good · Irritability/crying

Free text: Night terror last night. She doesn't usually have them.

MedDRA releases: 2024-11 · check-in free text available
2022-06-25
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · None

Under 3 check-in
2022-06-26
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · None

Under 3 check-in
2022-06-27
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · None

Under 3 check-in
2022-06-28
Health check-in — day 7, dose 1, under 3
Feeling: Good · None

Under 3 check-in
2022-07-05
Survey response — day 14, dose 1, under 3
MedDRA: Cough, Injection site rash, Office visit, Pyrexia, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fever, rash at injection site, coughing, runny nose. · Healthcare visit (other): Pediatrician visit

MedDRA releases: 2024-11 · check-in free text available
2022-07-05
Report sent to call center — day 14, dose 1, under 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-06
Call 1 — Left Voicemail
2022-07-06
Call successful
Does not wish to fill out VAERS report
2022-07-12
Health check-in — day 21, dose 1, under 3
Feeling: Good

Under 3 check-in
2022-07-19
Dose 2 — Moderna
2022-07-19
Health check-in — day 0, dose 2, under 3
Feeling: Good · Site: Redness · None

Under 3 check-in
2022-07-20
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Fair · Site: Pain, Redness, Swelling/hardness · Sleepiness, Irritability/crying, Loss of appetite

Under 3 check-in
2022-07-21
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · Site: Redness, Swelling/hardness · Irritability/crying

Under 3 check-in
2022-07-22
Survey response — days 1–6 daily, dose 2, under 3
MedDRA: Sleep terror, Vaccine positive rechallenge — Feeling: Good · Site: Redness, Swelling/hardness

Free text: Had another night terror last night, same as after the first dose. Toddler does not usually have night terrors

MedDRA releases: 2024-11 · check-in free text available
2022-07-23
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · Site: Swelling/hardness · None

Under 3 check-in
2022-07-24
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · Site: Swelling/hardness · None

Under 3 check-in
2022-07-25
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · Site: Swelling/hardness · None

Under 3 check-in
2022-07-26
Health check-in — day 7, dose 2, under 3
Feeling: Good · Site: Swelling/hardness · None

Under 3 check-in
2022-08-02
Health check-in — day 14, dose 2, under 3
Feeling: Good

Under 3 check-in
2022-08-09
Health check-in — day 21, dose 2, under 3
Feeling: Good

Under 3 check-in
2022-08-16
Health check-in — day 28, dose 2, under 3
Feeling: Good

Under 3 check-in
2022-08-25
Health check-in — day 35, dose 2, under 3
Feeling: Good

Under 3 check-in
2022-08-30
Health check-in — day 42, dose 2, under 3
Feeling: Good

Under 3 check-in
2022-10-18
Survey response — 3 months, dose 2, under 3
MedDRA: Conjunctivitis, Cough, Decreased appetite, Ear infection, Fatigue, Office visit, Pyrexia, Rhinorrhoea — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Cough, runny nose, fever, loss of appetite, conjunctivitis, ear infection, fatigue. The whole family was sick, and rapid tests and a PCR on one family member were all negative for COVID. · Healthcare visit (other): Pediatrician visit

MedDRA releases: 2024-11 · check-in free text available
2022-10-18
Report sent to call center — 3 months, dose 2, under 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-13
Dose 3 — Moderna
2022-12-13
Health check-in — day 0, dose 3, under 3
Feeling: Fair · Site: Pain · Irritability/crying

Under 3 check-in
2022-12-14
Health check-in — days 1–6 daily, dose 3, under 3
Feeling: Fair · Site: Pain, Redness, Swelling/hardness · Sleepiness, Irritability/crying, Loss of appetite · Be unable to do your normal daily activities

Under 3 check-in
2022-12-15
Health check-in — days 1–6 daily, dose 3, under 3
Feeling: Good · Site: Redness, Swelling/hardness · Irritability/crying

Under 3 check-in
2022-12-17
Health check-in — days 1–6 daily, dose 3, under 3
Feeling: Fair · Site: Pain, Redness, Swelling/hardness · Sleepiness, Irritability/crying

Under 3 check-in
2022-12-18
Health check-in — days 1–6 daily, dose 3, under 3
Feeling: Good · Site: Redness, Swelling/hardness · Irritability/crying

Under 3 check-in
2022-12-19
Health check-in — days 1–6 daily, dose 3, under 3
Feeling: Good · Irritability/crying

Under 3 check-in
2022-12-20
Health check-in — day 7, dose 3, under 3
Feeling: Fair · Irritability/crying

Under 3 check-in
2022-12-27
Health check-in — day 14, dose 3, under 3
Feeling: Good

Under 3 check-in
2023-01-03
Health check-in — day 21, dose 3, under 3
Feeling: Good

Under 3 check-in
2023-01-10
Health check-in — day 28, dose 3, under 3
Feeling: Good

Under 3 check-in
2023-01-19
Health check-in — day 35, dose 3, under 3
Feeling: Good

Under 3 check-in
2023-01-24
Survey response — day 42, dose 3, under 3
MedDRA: Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-03-14
Survey response — 3 months, dose 3, under 3
MedDRA: Nasopharyngitis, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-03-14
Report sent to call center — 3 months, dose 3, under 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2023-03-15
Call successful
Not applicable - Accidental Reporting
2023-06-13
Survey response — 6 months, dose 3, under 3
MedDRA: Hand-foot-and-mouth disease, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-06-13
Call case (no matching report) — Successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-06-14
Call 1 — Left Voicemail
2023-06-16
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2022-06-21	Moderna	No
2	2022-07-19	Moderna	No
3	2022-12-13	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-07-05	Successful 2022-07-06	Does not wish to fill out VAERS report
2022-10-18	Successful 2022-10-19	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-14	Successful 2023-03-15	Not applicable - Accidental Reporting
2023-06-13	Successful 2023-06-16	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 12 (Under 3) — days 1–6 daily, dose 1, under 3

2022-06-23

Systemic reaction (other): Night terror last night. She doesn't usually have them.

Release 12 (Under 3) — day 14, dose 1, under 3

2022-07-05

Symptoms: Fever, rash at injection site, coughing, runny nose.

Healthcare visit (other): Pediatrician visit

Release 12 (Under 3) — days 1–6 daily, dose 2, under 3

2022-07-22

Systemic reaction (other): Had another night terror last night, same as after the first dose. Toddler does not usually have night terrors

Release 12 (Under 3) — 3 months, dose 2, under 3

2022-10-18

Symptoms: Cough, runny nose, fever, loss of appetite, conjunctivitis, ear infection, fatigue. The whole family was sick, and rapid tests and a PCR on one family member were all negative for COVID.

Healthcare visit (other): Pediatrician visit

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
HCVO	Office visit	·	·	✓
SD	Conjunctivitis	·	·	✓
SD	Cough	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Ear infection	·	·	✓
SD	Fatigue	·	·	✓
SD	Hand-foot-and-mouth disease	·	·	✓
SD	Injection site rash	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Sleep terror	·	·	✓
SRO	Vaccine positive rechallenge	·	·	✓

✓ active code · ○ coded but marked inactive · blank = not in that release