Y4W-84122-68151

2 vaccinations 5 coded responses 21 check-ins 5 free-text entries 5 call cases

Sex: Male
Age at first dose: 0-4
ZIP prefix: 402 / KY
Registered: 2022-06-30

Relationship: Child or adolescent in my care
Guardian: T4X-54947-92148
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

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

2022-06-25
Dose 1 — Moderna
2022-06-30
Registered in v-safe
2022-06-30
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · Sleepiness

Under 3 check-in
2022-07-01
Health check-in — days 1–6 daily, dose 1, under 3
Feeling: Good · Sleepiness

Under 3 check-in
2022-07-02
Health check-in — day 7, dose 1, under 3
Feeling: Fair · Sleepiness, Irritability/crying · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Under 3 check-in
2022-07-02
Report sent to call center — day 7, dose 1, under 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-05
Call 1 — Left Voicemail
2022-07-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-09
Survey response — day 14, dose 1, under 3
MedDRA: Ear infection, Respiratory syncytial virus 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 · Outpatient clinic or urgent care clinic visit

Free text: Ear infections and RSV

MedDRA releases: 2024-11 · check-in free text available
2022-07-09
Report sent to call center — day 14, 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)
2022-07-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-16
Health check-in — day 21, dose 1, under 3
Feeling: Good

Under 3 check-in
2022-07-23
Health check-in — day 28, dose 1, under 3
Feeling: Good

Under 3 check-in
2022-07-30
Dose 2 — Moderna
2022-07-30
Health check-in — day 0, dose 2, under 3
Feeling: Good · None

Under 3 check-in
2022-07-31
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · Irritability/crying

Under 3 check-in
2022-08-01
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · Fever · Sleepiness

Under 3 check-in
2022-08-02
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · None

Under 3 check-in
2022-08-03
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · None

Under 3 check-in
2022-08-04
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · Sleepiness

Under 3 check-in
2022-08-05
Health check-in — days 1–6 daily, dose 2, under 3
Feeling: Good · None

Under 3 check-in
2022-08-06
Health check-in — day 7, dose 2, under 3
Feeling: Good · None

Under 3 check-in
2022-08-13
Health check-in — day 14, dose 2, under 3
Feeling: Good

Under 3 check-in
2022-08-20
Survey response — day 21, dose 2, under 3
MedDRA: Cough, Ear infection, Hypersomnia, Irritability, Pyrexia, Rhinorrhoea, Viral infection — 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 · Outpatient clinic or urgent care clinic visit

Free text: Some type of virus and two ear infections. Lots of runny nose, fever (rectal 104.1 on Monday and slowly decreased to normal on Thursday), light coughing, lots of sleep, lots of fussiness.

MedDRA releases: 2024-11 · check-in free text available
2022-08-20
Report sent to call center — day 21, dose 2, 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)
2022-08-22
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-27
Health check-in — day 28, dose 2, under 3
Feeling: Good

Under 3 check-in
2022-09-03
Survey response — day 35, dose 2, under 3
MedDRA: Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative — 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

Free text: Has had spiking temperatures from 95.7 to 102.6 since Wednesday morning. Tested negative for Covid on Wednesday and the parents have tested negative for Covid multiple times this week. The only symptoms are the child's fever and very mild congestion.

MedDRA releases: 2024-11 · check-in free text available
2022-09-03
Report sent to call center — day 35, dose 2, under 3
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)
2022-09-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-10
Survey response — day 42, dose 2, under 3
MedDRA: Cough, Croup infectious, Wheezing — Feeling: Fair

Free text: Appears to have croup. Barky cough and some wheezing.

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Survey response — 3 months, dose 2, under 3
MedDRA: Ear infection, Viral 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 · Outpatient clinic or urgent care clinic visit

Free text: Some type of viral infection and double ear infection

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Report sent to call center — 3 months, dose 2, 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)
2022-10-31
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-28
Health check-in — 6 months, dose 2, under 3
Feeling: Good

Under 3 check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2022-06-25	Moderna	No
2	2022-07-30	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-07-02	Successful 2022-07-05	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-09	Successful 2022-07-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-20	Successful 2022-08-22	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-03	Successful 2022-09-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-29	Successful 2022-10-31	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

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

2022-07-09

Symptoms: Ear infections and RSV

Release 12 (Under 3) — day 21, dose 2, under 3

2022-08-20

Symptoms: Some type of virus and two ear infections. Lots of runny nose, fever (rectal 104.1 on Monday and slowly decreased to normal on Thursday), light coughing, lots of sleep, lots of fussiness.

Release 12 (Under 3) — day 35, dose 2, under 3

2022-09-03

Symptoms: Has had spiking temperatures from 95.7 to 102.6 since Wednesday morning. Tested negative for Covid on Wednesday and the parents have tested negative for Covid multiple times this week. The only symptoms are the child's fever and very mild congestion. cut off by CDC

Release 12 (Under 3) — day 42, dose 2, under 3

2022-09-10

Symptoms: Appears to have croup. Barky cough and some wheezing.

Release 12 (Under 3) — 3 months, dose 2, under 3

2022-10-29

Symptoms: Some type of viral infection and double ear infection

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	Cough	·	·	✓
SD	Croup infectious	·	·	✓
SD	Ear infection	·	·	✓
SD	Hypersomnia	·	·	✓
SD	Irritability	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory syncytial virus infection	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Viral infection	·	·	✓
SD	Wheezing	·	·	✓

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