R8K-27750-02887
4 vaccinations
2 coded responses
18 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 199 / DE
- Registered
- 2022-01-11
- Relationship
- Adult relative or friend
- Guardian
- NWR-34965-36178
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-02
Dose 1 — Moderna
-
2021-04-30
Dose 2 — Moderna
-
2021-12-27
Dose 3 — Pfizer-BioNTech
-
2022-01-11
Registered in v-safe
- 2022-01-11
- 2022-01-17
- 2022-01-24
- 2022-01-31
- 2022-02-07
- 2022-03-30
-
2022-05-21
Dose 4 — Pfizer-BioNTech
-
2022-05-23
Health check-in — days 1–6 daily, dose 4, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-05-26
- 2022-05-27
- 2022-05-28
- 2022-06-04
- 2022-06-11
- 2022-06-18
- 2022-06-25
- 2022-07-03
-
2022-11-21
Survey response — 6 months, dose 4, dependentMedDRA: Croup infectious, Syncope — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: He fainted on Sunday November 13th, 2022 30 minutes after he had his breakfast while was still sitting on the chair in dinning room. Two weeks before he had croup, our 6 year old had it too first. He is going to physicians to know why he fainted.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-21
Report sent to call center — 6 months, dose 4, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-22
Survey response — 6 months, dose 4MedDRA: Croup infectious, Influenza like illness — Feeling: GoodFree text: Flu like symptoms. Croup.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-22
Call successfulCompleted over the phone
- 2023-05-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-02 | Moderna | No |
| 2 | 2021-04-30 | Moderna | No |
| 3 | 2021-12-27 | Pfizer-BioNTech | No |
| 4 | 2022-05-21 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 12 — 6 months, dose 4, dependent
Symptoms: He fainted on Sunday November 13th, 2022 30 minutes after he had his breakfast while was still sitting on the chair in dinning room. Two weeks before he had croup, our 6 year old had it too first. He is going to physicians to know why he fainted.
Release 12 — 6 months, dose 4
Symptoms: Flu like symptoms. Croup.
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 | Croup infectious | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Syncope | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release