TS7-51365-50306

3 vaccinations 4 coded responses 30 check-ins 2 free-text entries 3 call cases

Sex: Male
Age at first dose: 0-4
ZIP prefix: 750 / TX
Registered: 2022-06-22

Relationship: Child or adolescent in my care
Guardian: Z6L-35978-26448
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2022-06-21
Dose 1 — Moderna
2022-06-22
Registered in v-safe
2022-06-22
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-06-23
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-06-24
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-06-25
Health check-in — days 1–6 daily, dose 1, dependent
Feeling: Good · None

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

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

Adult check-in
2022-06-28
Health check-in — day 7, dose 1, dependent
Feeling: Good · None

Adult check-in
2022-07-05
Health check-in — day 14, dose 1, dependent
Feeling: Good

Adult check-in
2022-07-12
Health check-in — day 21, dose 1, dependent
Feeling: Good

Adult check-in
2022-07-19
Dose 2 — Moderna
2022-07-19
Health check-in — day 0, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-20
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-21
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-22
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-23
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-24
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-25
Health check-in — days 1–6 daily, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-07-26
Health check-in — day 7, dose 2, dependent
Feeling: Good · None

Adult check-in
2022-08-02
Health check-in — day 14, dose 2, dependent
Feeling: Good

Adult check-in
2022-08-09
Health check-in — day 21, dose 2, dependent
Feeling: Good

Adult check-in
2022-08-16
Health check-in — day 28, dose 2, dependent
Feeling: Good

Adult check-in
2022-08-25
Survey response — day 35, dose 2, dependent
MedDRA: Cough, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fever, runny nose, cough (negative COVID test)

MedDRA releases: 2024-11 · check-in free text available
2022-08-30
Health check-in — day 42, dose 2, dependent
Feeling: Good

Adult check-in
2022-10-18
Survey response — 3 months, dose 2, dependent
MedDRA: Cough, Ear infection, Office visit, Pyrexia, Rhinorrhoea — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: He had an ear infection a few weeks ago, now he has a runny nose, cough, and low fever. · Healthcare visit (other): Pediatrician office visit

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

1 call case(s)
2022-10-19
Call 1 — Left Voicemail
2022-10-19
Callback requested for
02:00PM ET
2022-10-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-27
Dose 3 — Moderna
2023-01-17
Health check-in — 6 months, dose 2, dependent
Feeling: Good

Adult check-in
2023-01-17
Health check-in — day 21, dose 3, dependent
Feeling: Good

Adult check-in
2023-01-24
Survey response — day 28, dose 3, dependent
MedDRA: Ear infection, Pyrexia — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-01-24
Report sent to call center — day 28, dose 3, dependent
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)
2023-01-25
Call 1 — Left Voicemail
2023-01-25
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-31
Health check-in — day 35, dose 3, dependent
Feeling: Good

Adult check-in
2023-02-07
Health check-in — day 42, dose 3, dependent
Feeling: Good

Adult check-in
2023-03-29
Survey response — 3 months, dose 3, dependent
MedDRA: Ear infection, Office visit — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-29
Report sent to call center — 3 months, dose 3, dependent
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)
2023-03-30
Call 1 — Left Voicemail
2023-03-31
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-06-27
Health check-in — 6 months, dose 3, dependent
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2022-06-21	Moderna	No
2	2022-07-19	Moderna	No
3	2022-12-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-10-18	Successful 2022-10-19	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-24	Successful 2023-01-25	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-29	Successful 2023-03-31	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 12 — day 35, dose 2, dependent

2022-08-25

Symptoms: Fever, runny nose, cough (negative COVID test)

Release 12 — 3 months, dose 2, dependent

2022-10-18

Symptoms: He had an ear infection a few weeks ago, now he has a runny nose, cough, and low fever.

Healthcare visit (other): Pediatrician office 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	Cough	·	·	✓
SD	Ear infection	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓

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