XF7-21352-53022
2 vaccinations
2 coded responses
24 check-ins
2 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 066 / CT
- Registered
- 2022-07-23
- Relationship
- Child or adolescent in my care
- Guardian
- W7J-12994-13721
- Race
- Multiracial
- Ethnicity
- Hispanic or Latino
Timeline
-
2022-07-23
Registered in v-safe
-
2022-07-23
Dose 1 — Moderna
-
2022-07-24
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Fever · Fatigue or tirednessAdult check-in
- 2022-07-25
- 2022-07-26
- 2022-07-27
- 2022-07-28
- 2022-07-29
- 2022-07-30
- 2022-08-06
-
2022-08-13
Survey response — day 21, dose 1, dependentMedDRA: Condition aggravated, Pre-existing disease — 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, HospitalizationFree text: Reactive airway disease exacerbationMedDRA releases: 2024-11 · check-in free text available
-
2022-08-13
Report sent to call center — day 21, dose 1, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-08-15
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-08-20
Dose 2 — Moderna
- 2022-08-20
- 2022-08-21
- 2022-08-22
- 2022-08-23
- 2022-08-24
- 2022-08-25
- 2022-08-26
- 2022-08-27
- 2022-09-03
- 2022-09-10
- 2022-09-17
- 2022-09-24
-
2022-10-01
Survey response — day 42, dose 2, dependentMedDRA: Asthma, Respiratory tract infection, Wheezing — 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 · Outpatient clinic or urgent care clinic visitFree text: Non-COVID respiratory infection leading to wheezing; diagnosed with asthmaMedDRA releases: 2024-11 · check-in free text available
-
2022-10-01
Report sent to call center — day 42, dose 2, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-10-03
-
2022-10-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-11-19
- 2023-02-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-07-23 | Moderna | No |
| 2 | 2022-08-20 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-08-13 | Successful 2022-08-15 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-10-01 | Successful 2022-10-03 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 — day 21, dose 1, dependent
Symptoms: Reactive airway disease exacerbation
Release 12 — day 42, dose 2, dependent
Symptoms: Non-COVID respiratory infection leading to wheezing; diagnosed with asthma
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 | Asthma | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory tract infection | · | · | ✓ |
| SD | Wheezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release