PQT-12905-09950
2 vaccinations
3 coded responses
21 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 761 / TX
- Registered
- 2022-09-30
- Relationship
- Child or adolescent in my care
- Guardian
- 3U8-20006-29366
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-09-30
Registered in v-safe
-
2022-09-30
Dose 1 — Moderna
-
2022-09-30
Health check-in — day 0, dose 1, under 3Feeling: Fair · Site: Swelling/hardness · Sleepiness, Irritability/cryingUnder 3 check-in
- 2022-10-01
- 2022-10-02
- 2022-10-03
-
2022-10-04
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Fair · Irritability/cryingUnder 3 check-in
- 2022-10-05
- 2022-10-07
- 2022-10-16
- 2022-10-21
-
2022-10-28
Dose 2 — Moderna
-
2022-10-28
Health check-in — day 0, dose 2, under 3Feeling: Fair · Site: Pain · Sleepiness, Irritability/crying, Loss of appetiteUnder 3 check-in
-
2022-10-29
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Irritability/cryingUnder 3 check-in
-
2022-10-30
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Irritability/cryingUnder 3 check-in
-
2022-10-31
Survey response — days 1–6 daily, dose 2, under 3MedDRA: Ear infection — Feeling: Poor · Irritability/crying, Loss of appetiteFree text: Ear infectionMedDRA releases: 2024-11 · check-in free text available
- 2022-11-01
- 2022-11-03
-
2022-11-04
Health check-in — day 7, dose 2, under 3Feeling: Fair · Irritability/crying, DiarrheaUnder 3 check-in
-
2022-11-13
Survey response — day 14, dose 2, under 3MedDRA: Cough, Ear infection — Feeling: FairFree text: Cough, ear infectionMedDRA releases: 2024-11 · check-in free text available
- 2022-11-18
-
2022-11-27
Survey response — day 28, dose 2, under 3MedDRA: Bronchiolitis, Ear infection — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Ear infection and bronchiolitisMedDRA releases: 2024-11 · check-in free text available
-
2022-11-27
Report sent to call center — day 28, dose 2, under 3Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-28
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-12-02
- 2022-12-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-09-30 | Moderna | No |
| 2 | 2022-10-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-27 | Successful 2022-11-28 |
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 2, under 3
Systemic reaction (other): Ear infection
Release 12 (Under 3) — day 14, dose 2, under 3
Symptoms: Cough, ear infection
Release 12 (Under 3) — day 28, dose 2, under 3
Symptoms: Ear infection and bronchiolitis
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 | Bronchiolitis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SRO | Ear infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release