UQ5-50427-03515

2 vaccinations 8 coded responses 17 check-ins 4 free-text entries 6 call cases

Sex: Male
Age at first dose: 0-4
ZIP prefix: 984 / WA
Registered: 2022-11-10

Relationship: Child or adolescent in my care
Guardian: YUT-57076-77394
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2022-11-10
Registered in v-safe
2022-11-10
Dose 1 — Moderna
Co-administered: Flu:Hepatitis B:Hib:Pneumonia:Polio:Rotavirus:Tetanus
2022-11-10
Health check-in — day 0, dose 1, under 3
Feeling: Fair · Fever · Sleepiness, Irritability/crying, Vomiting

Under 3 check-in
2022-11-11
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Fair · Fever · Sleepiness, Irritability/crying, Vomiting

Under 3 check-in
2022-11-12
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · Sleepiness

Under 3 check-in
2022-11-13
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · Sleepiness, Irritability/crying, Vomiting

Under 3 check-in
2022-11-14
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · Irritability/crying, Vomiting

Under 3 check-in
2022-11-16
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · Irritability/crying, Vomiting

Under 3 check-in
2022-11-17
Health check-in — day 7, dose 1, under 3
Feeling: Good · Sleepiness

Under 3 check-in
2022-11-24
Survey response — day 14, dose 1, under 3
MedDRA: Cough, Rash, Respiratory tract congestion, Surgery, Vomiting — Feeling: Fair

Free text: Rash, cough, congestion, vomiting, and he had surgery.

MedDRA releases: 2024-11 · check-in free text available
2022-12-01
Survey response — day 21, dose 1, under 3
MedDRA: Adenovirus infection, Rhinovirus infection — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Diagnosed with Rhinovirus and adenovirus

MedDRA releases: 2024-11 · check-in free text available
2022-12-01
Report sent to call center — day 21, dose 1, under 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-02
Call successful
Not applicable - Accidental Reporting
2022-12-09
Health check-in — day 28, dose 1, under 3
Feeling: Fair

Under 3 check-in
2022-12-15
Survey response — day 35, dose 1, under 3
MedDRA: Fatigue — Feeling: Fair · Be unable to work or attend school

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Survey response — day 42, dose 1, under 3
MedDRA: Cough, Eye discharge, Lacrimation increased, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Congestion, runny nose, cough, watery/goopy eyes

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Report sent to call center — day 42, dose 1, under 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-23
Call successful
Not applicable - Accidental Reporting
2023-02-11
Survey response — 3 months, dose 1, under 3
MedDRA: Ear infection, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-02-11
Report sent to call center — 3 months, dose 1, under 3
Get care from a doctor or other healthcare professional

1 call case(s)
2023-02-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-13
Dose 2 — Moderna
2023-04-11
Survey response — day 28, dose 2, under 3
MedDRA: Cough, Pyrexia, Respiratory tract congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-11
Report sent to call center — day 28, dose 2, under 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-12
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-17
Survey response — day 35, dose 2, under 3
MedDRA: Ear infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-17
Report sent to call center — day 35, dose 2, under 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-24
Health check-in — day 42, dose 2, under 3
Feeling: Good

Under 3 check-in
2023-06-13
Survey response — 3 months, dose 2, under 3
MedDRA: Febrile convulsion, Rhinovirus infection — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-06-13
Call case (no matching report) — Successful
Participant prefers to complete VAERS report online
2023-06-14
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2022-11-10	Moderna	Flu:Hepatitis B:Hib:Pneumonia:Polio:Rotavirus:Tetanus
2	2023-03-13	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-12-01	Successful 2022-12-02	Not applicable - Accidental Reporting
2022-12-22	Successful 2022-12-23	Not applicable - Accidental Reporting
2023-02-11	Successful 2023-02-13	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-11	Successful 2023-04-12	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-17	Successful 2023-04-18	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-06-13	Successful 2023-06-14	Participant prefers to complete VAERS report online

Free text

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

2022-11-24

Symptoms: Rash, cough, congestion, vomiting, and he had surgery.

Release 12 (Under 3) — day 21, dose 1, under 3

2022-12-01

Symptoms: Diagnosed with Rhinovirus and adenovirus

Release 12 (Under 3) — day 35, dose 1, under 3

2022-12-15

Symptoms: Fatigue

Release 12 (Under 3) — day 42, dose 1, under 3

2022-12-22

Symptoms: Congestion, runny nose, cough, watery/goopy eyes

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	Adenovirus infection	·	·	✓
SD	Cough	·	·	✓
SD	Ear infection	·	·	✓
SD	Eye discharge	·	·	✓
SD	Fatigue	·	·	✓
SD	Febrile convulsion	·	·	✓
SD	Lacrimation increased	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rash	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Rhinovirus infection	·	·	✓
SD	Surgery	·	·	✓
SD	Vomiting	·	·	✓

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