Y4X-10706-47757
3 vaccinations
3 coded responses
26 check-ins
0 free-text entries
3 call cases
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 126 / NY
- Registered
- 2022-12-31
- Relationship
- Child or adolescent in my care
- Guardian
- UZF-26679-48748
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-12-10
Dose 1 — Moderna
-
2022-12-31
Registered in v-safe
- 2022-12-31
- 2023-01-07
-
2023-01-11
Dose 2 — Moderna
-
2023-01-12
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Poor · Site: Pain · Sleepiness, Irritability/crying · Be unable to work or attend schoolUnder 3 check-in
-
2023-01-13
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Site: Pain, Swelling/hardness · Sleepiness, Irritability/crying, Loss of appetiteUnder 3 check-in
-
2023-01-14
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Sleepiness, Irritability/cryingUnder 3 check-in
- 2023-01-16
- 2023-01-17
- 2023-01-20
- 2023-01-26
- 2023-02-01
-
2023-02-10
Survey response — day 28, dose 2, under 3MedDRA: Cough, Respiratory tract congestion, Wheezing — 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 visitMedDRA releases: 2024-11
-
2023-02-10
Report sent to call center — day 28, dose 2, under 3Be 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)
-
2023-02-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-02-17
- 2023-02-22
-
2023-04-03
Dose 3 — Moderna
- 2023-04-03
- 2023-04-04
- 2023-04-05
- 2023-04-06
- 2023-04-07
- 2023-04-08
- 2023-04-09
- 2023-04-10
-
2023-04-17
Survey response — day 14, dose 3, under 3MedDRA: 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 visitMedDRA releases: 2024-11
-
2023-04-17
Report sent to call center — day 14, dose 3, under 3Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-04-18
-
2023-04-24
Survey response — day 21, dose 3, under 3MedDRA: Ear infection, Lower respiratory tract infection — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-04-24
Report sent to call center — day 21, dose 3, under 3Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-04-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2023-04-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-05-01
- 2023-05-08
- 2023-05-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-12-10 | Moderna | No |
| 2 | 2023-01-11 | Moderna | No |
| 3 | 2023-04-03 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-02-10 | Successful 2023-02-13 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2023-04-17 | Successful 2023-04-25 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2023-04-24 | Successful 2023-04-25 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
None.
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 | Ear infection | · | · | ✓ |
| SD | Lower respiratory tract infection | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Wheezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release