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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

  1. 2022-09-30
    Registered in v-safe
  2. 2022-09-30
    Dose 1 — Moderna
  3. 2022-09-30
    Health check-in — day 0, dose 1, under 3
    Feeling: Fair · Site: Swelling/hardness · Sleepiness, Irritability/crying
    Under 3 check-in
  4. 2022-10-01
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  5. 2022-10-02
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  6. 2022-10-03
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  7. 2022-10-04
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Fair · Irritability/crying
    Under 3 check-in
  8. 2022-10-05
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · Loss of appetite
    Under 3 check-in
  9. 2022-10-07
    Health check-in — day 7, dose 1, under 3
    Feeling: Fair · Irritability/crying
    Under 3 check-in
  10. 2022-10-16
    Health check-in — day 14, dose 1, under 3
    Feeling: Good
    Under 3 check-in
  11. 2022-10-21
    Health check-in — day 21, dose 1, under 3
    Feeling: Good
    Under 3 check-in
  12. 2022-10-28
    Dose 2 — Moderna
  13. 2022-10-28
    Health check-in — day 0, dose 2, under 3
    Feeling: Fair · Site: Pain · Sleepiness, Irritability/crying, Loss of appetite
    Under 3 check-in
  14. 2022-10-29
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Fair · Irritability/crying
    Under 3 check-in
  15. 2022-10-30
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Fair · Irritability/crying
    Under 3 check-in
  16. 2022-10-31
    Survey response — days 1–6 daily, dose 2, under 3
    MedDRA: Ear infection — Feeling: Poor · Irritability/crying, Loss of appetite
    Free text: Ear infection
    MedDRA releases: 2024-11 · check-in free text available
  17. 2022-11-01
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Good · Diarrhea
    Under 3 check-in
  18. 2022-11-03
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Fair · Diarrhea
    Under 3 check-in
  19. 2022-11-04
    Health check-in — day 7, dose 2, under 3
    Feeling: Fair · Irritability/crying, Diarrhea
    Under 3 check-in
  20. 2022-11-13
    Survey response — day 14, dose 2, under 3
    MedDRA: Cough, Ear infection — Feeling: Fair
    Free text: Cough, ear infection
    MedDRA releases: 2024-11 · check-in free text available
  21. 2022-11-18
    Health check-in — day 21, dose 2, under 3
    Feeling: Fair
    Under 3 check-in
  22. 2022-11-27
    Survey response — day 28, dose 2, under 3
    MedDRA: 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 visit
    Free text: Ear infection and bronchiolitis
    MedDRA releases: 2024-11 · check-in free text available
  23. 2022-11-27
    Report sent to call center — day 28, dose 2, under 3
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  24. 2022-11-28
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  25. 2022-12-02
    Health check-in — day 35, dose 2, under 3
    Feeling: Good
    Under 3 check-in
  26. 2022-12-09
    Health check-in — day 42, dose 2, under 3
    Feeling: Fair
    Under 3 check-in

Vaccinations

DoseDateManufacturerCo-administered
12022-09-30Moderna No
22022-10-28Moderna No

Call center

ReportedOutcomeVAERS-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

2022-10-31

Systemic reaction (other): Ear infection

Release 12 (Under 3) — day 14, dose 2, under 3

2022-11-13

Symptoms: Cough, ear infection

Release 12 (Under 3) — day 28, dose 2, under 3

2022-11-27

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

FieldPreferred term2021-092023-042024-11
SDBronchiolitis · · ✓
SDCough · · ✓
SDEar infection · · ✓
SROEar infection · · ✓

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