VFT-20927-35467
2 vaccinations
5 coded responses
12 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 481 / MI
- Registered
- 2022-06-25
- Relationship
- Child or adolescent in my care
- Guardian
- W4M-45220-65948
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-25
Registered in v-safe
-
2022-06-25
Dose 1 — Moderna
- 2022-06-25
- 2022-06-26
-
2022-06-29
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Good · Site: Redness · NoneUnder 3 check-in
- 2022-07-09
-
2022-07-18
Survey response — day 21, dose 1, under 3MedDRA: Conjunctivitis, Periorbital oedema, Rhinorrhoea, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Runny nose, periorbital edema, conjunctivitis · Healthcare visit (other): I have placed a calm to office, most concerned about eyesMedDRA releases: 2024-11 · check-in free text available
-
2022-07-18
Report sent to call center — day 21, dose 1, under 3Get care from a doctor or other healthcare professional1 call case(s)
-
2022-07-19
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-07-23
- 2022-07-30
-
2022-08-02
Dose 2 — Moderna
-
2022-08-07
Survey response — days 1–6 daily, dose 2, under 3MedDRA: Nausea, Pyrexia, Vomiting — Feeling: GoodFree text: Had several episodes of nausea and vomiting day after vaccine, also subjective fever. Had to give zofran, had to miss daycareMedDRA releases: 2024-11 · check-in free text available
-
2022-08-16
Survey response — day 14, dose 2, under 3MedDRA: SARS-CoV-2 test negative, Viral infection — Feeling: GoodFree text: New viral infection, home test negative for COVIDMedDRA releases: 2024-11 · check-in free text available
-
2022-09-01
Survey response — day 28, dose 2, under 3MedDRA: Cough, Pyrexia, Respiratory symptom, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend schoolFree text: Uri symptoms, cough, fever, home test negative for COVIDMedDRA releases: 2024-11 · check-in free text available
- 2022-11-01
-
2023-01-31
Survey response — 6 months, dose 2, under 3MedDRA: Nasopharyngitis — Feeling: Good · Be unable to work or attend schoolMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-25 | Moderna | No |
| 2 | 2022-08-02 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-07-18 | Successful 2022-07-19 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 (Under 3) — day 21, dose 1, under 3
Symptoms: Runny nose, periorbital edema, conjunctivitis
Healthcare visit (other): I have placed a calm to office, most concerned about eyes
Release 12 (Under 3) — days 1–6 daily, dose 2, under 3
Systemic reaction (other): Had several episodes of nausea and vomiting day after vaccine, also subjective fever. Had to give zofran, had to miss daycare
Release 12 (Under 3) — day 14, dose 2, under 3
Symptoms: New viral infection, home test negative for COVID
Release 12 (Under 3) — day 28, dose 2, under 3
Symptoms: Uri symptoms, cough, fever, home test negative for COVID
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 | Unevaluable event | · | · | ✓ |
| SD | Conjunctivitis | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Periorbital oedema | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory symptom | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Nausea | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release