What the pattern is #
On a v-safe health check-in, a parent or registrant can tick Hospitalization
(often together with emergency-room or clinic care). That checkbox is a direct, structured claim that the
vaccinated person was admitted. Separately, coding attaches MedDRA preferred terms
(PT_NAME). The usual preferred term for an inpatient admission is Hospitalisation.
Across these MMWR briefs, reconstruction from the v-safe dataset repeatedly finds the same mismatch:
the Hospitalization checkbox is present, symptom or procedure codes may be attached, but the
Hospitalisation preferred term is absent on that response.
Why missing PT_NAME / Hospitalisation matters #
1. Checkboxes and preferred terms answer different questions for analysts
The hospitalization checkbox lives on the survey response. The MedDRA preferred term
lives in the coding layer that many safety workflows treat as the searchable, countable vocabulary.
Filtering on PT_NAME = Hospitalisation drops rows that only have the checkbox—even when
Appendicitis or Chest pain codes remain.
2. Papers narrate “hospitalizations” while coding erases the inpatient setting
Results prose often cites a small hospitalization count, then softens it (“unrelated,” “error”).
Meanwhile coding fails to stamp Hospitalisation on most of those responses. The public story
and the coded database diverge.
3. Symptom codes without the setting PT look like outpatient diagnoses
A response coded only Chest pain; Dyspnoea or Appendicitis; Appendicectomy—without
Hospitalisation—can be read without an inpatient frame even when free text says “Appendectomy.”
4. Absolute “no hospital” claims become harder to catch from codes alone
Reviewers who only query Hospitalisation may falsely confirm emptiness while checkbox rows
(still without the PT) contradict the claim.
5. Follow-up failure compounds the gap
Many under-coded hospital rows also close as GDIT Unsuccessful, while the memorable sentence remains the soft disposition among those with “additional information.”
How v-safe checkboxes and MedDRA interact #
- Check-in selects care settings (clinic, telehealth, ER/ED, and/or hospitalization).
- Optional free text describes symptoms or visit reasons.
- Coders map text to MedDRA preferred terms—including, when done correctly,
Hospitalisation. - Call-center / GDIT follow-up may succeed or fail (Unsuccessful).
The anomaly is step 3 failing for the setting while steps 1–2 often succeed. Full extract: 889 under-coded hospital response rows; 714 distinct paper×registrant pairs.
Cross-paper counts #
| Paper | Title | Distinct registrants | Response rows | With any MedDRA PT | With free text |
|---|---|---|---|---|---|
| mm7008e3 | First Month of COVID-19 Vaccine Safety Monitoring — United States, December 14, 2020–January 13, 2021 | 169 | 200 | 169 | 123 |
| mm7018e2 | Safety Monitoring of the Janssen (Johnson & Johnson) COVID-19 Vaccine — United States, March–April 2021 | 104 | 139 | 96 | 39 |
| mm7031e1 | COVID-19 Vaccine Safety in Adolescents Aged 12–17 Years — United States, December 14, 2020–July 16, 2021 | 23 | 31 | 17 | 4 |
| mm7039e4 | Safety Monitoring of an Additional Dose of COVID-19 Vaccine — United States, August 12–September 19, 2021 | 11 | 13 | 9 | 5 |
| mm705152a1 | COVID-19 Vaccine Safety in Children Aged 5–11 Years — United States, November 3–December 19, 2021 | 13 | 15 | 9 | 6 |
| mm7107e1 | Safety Monitoring of COVID-19 Vaccine Booster Doses Among Adults — United States, September 22, 2021–February 6, 2022 | 242 | 311 | 228 | 99 |
| mm7109e2 | Safety Monitoring of COVID-19 Vaccine Booster Doses Among Persons Aged 12–17 Years — United States, December 9, 2021–February 20, 2022 | 2 | 3 | 2 | 2 |
| mm7128a3 | Safety Monitoring of COVID-19 mRNA Vaccine First Booster Doses Among Persons Aged ≥12 Years With Presumed Immunocompromise Status — United States, January 12–March 28, 2022 | 1 | 1 | 1 | 1 |
| mm7130a4 | Safety Monitoring of COVID-19 mRNA Vaccine Second Booster Doses Among Adults Aged ≥50 Years — United States, March 29–July 10, 2022 | 78 | 93 | 65 | 29 |
| mm7133a3 | Safety Monitoring of Pfizer-BioNTech COVID-19 Vaccine Booster Doses Among Children Aged 5–11 Years — United States, May 17–July 31, 2022 | 1 | 1 | 1 | 0 |
| mm7135a3 | COVID-19 mRNA Vaccine Safety Among Children Aged 6 Months–5 Years — United States, June 18–August 21, 2022 | 1 | 2 | 1 | 0 |
| mm7144a3 | Safety Monitoring of Bivalent COVID-19 mRNA Vaccine Booster Doses Among Persons Aged ≥12 Years — United States, August 31–October 23, 2022 | 60 | 71 | 56 | 29 |
| mm7202a5 | Safety Monitoring of Bivalent COVID-19 mRNA Vaccine Booster Doses Among Children Aged 5–11 Years — United States, October 12–January 1, 2023 | 3 | 3 | 3 | 0 |
| mm7223a2 | Safety Monitoring of mRNA COVID-19 Vaccine Third Doses Among Children Aged 6 Months–5 Years — United States, June 17, 2022–May 7, 2023 | 6 | 6 | 6 | 1 |
Total under-coded hospital response rows: 889.
Paper quotes ↔ registrant examples #
For each paper, the left column is verbatim MMWR language (as captured in the anomaly reports). The right column is under-coded hospital-checkbox registrant examples from the same brief. Use Show more when a column is taller than the default window so the two sides stay readable side by side.
mm7133a3 — Safety Monitoring of Pfizer-BioNTech COVID-19 Vaccine Booster Doses Among Children Aged 5–11 Years — United States, May 17–July 31, 2022 #
Anomaly report: mm7133a3. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Results): “Approximately 1.0% of parents reported seeking medical care for their child after third dose vaccination… No children received care at a hospital after third dose vaccination.” Paper (Results / Table 2): Hospitalization after dose 3 = 0. Paper (Methods): “CDC’s v-safe call center contacts parents who indicate that medical care was sought for their child after vaccination and encourages completion of a VAERS report, if indicated.” |
|
mm7144a3 — Safety Monitoring of Bivalent COVID-19 mRNA Vaccine Booster Doses Among Persons Aged ≥12 Years — United States, August 31–October 23, 2022 #
Anomaly report: mm7144a3. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Results): “Receipt of medical care was reported by 0.8% of registrants… Hospitalization was reported by 55 (0.03%) registrants. Among 45 registrants with information about the hospitalization available from the v-safe call center or free text message response, 29 indicated that the hospitalization was unrelated to vaccination, 13 completed a VAERS report, and three did not wish to complete a VAERS report.” Paper (Table 2): Hospitalization row printed as 0 / 0 / 0 / 0 / 0 for every age group and the total. Paper (Table 2): Hospitalization = 0 for ages 12–17, 18–49, 50–64, ≥65, and Total. Paper (Results): “Hospitalization was reported by 55 (0.03%) registrants.” |
|
mm7109e2 — Safety Monitoring of COVID-19 Vaccine Booster Doses Among Persons Aged 12–17 Years — United States, December 9, 2021–February 20, 2022 #
Anomaly report: mm7109e2. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Results): “One (0.03%) adolescent received care at a hospital during the week after booster dose vaccination for treatment of a new onset migraine; whether hospitalization was the result of vaccination could not be determined.” Paper (Methods): “CDC’s v-safe call center contacts registrants who indicate that medical care was sought after vaccination and encourages completion of a VAERS report, if indicated.” |
|
mm705152a1 — COVID-19 Vaccine Safety in Children Aged 5–11 Years — United States, November 3–December 19, 2021 #
Anomaly report: mm705152a1. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Results): “Approximately 1% of parents reported seeking medical care in the week after vaccination… Fourteen (0.02%) children reportedly received care at a hospital; information regarding reason for hospitalization was available for five children… Parents and guardians of all hospitalized children were contacted; two parents completed VAERS reports, and one revealed hospitalization was reported in error.” Paper (Results): Fourteen hospital reports; reasons for five (appendicitis ×2, vomiting/dehydration, respiratory infection, retropharyngeal cellulitis); all parents contacted; two VAERS; one hospitalization “reported in error.” |
|
mm7202a5 — Safety Monitoring of Bivalent COVID-19 mRNA Vaccine Booster Doses Among Children Aged 5–11 Years — United States, October 12–January 1, 2023 #
Anomaly report: mm7202a5. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Results): “…most commonly in an outpatient clinic (37; 1.1%); no children received hospital care. Of the 64 reports of medical care sought, 37 had additional information available; parents or guardians of 35 children reported that seeking care was unrelated to vaccination.” Paper (Results / Table 2): Hospitalization = 0 (—) for Pfizer, Moderna, and Total. Prose: “no children received hospital care.” Paper (Summary): “Most reports to v-safe of children who received medical care after bivalent booster vaccination indicated that care was not related to vaccination.” |
|
mm7031e1 — COVID-19 Vaccine Safety in Adolescents Aged 12–17 Years — United States, December 14, 2020–July 16, 2021 #
Anomaly report: mm7031e1. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Discussion): “A small number of v-safe participants reported they were hospitalized after vaccination; however, v-safe does not record reason for hospitalization, and it cannot be determined whether hospitalization was related to vaccination.” |
|
mm7107e1 — Safety Monitoring of COVID-19 Vaccine Booster Doses Among Adults — United States, September 22, 2021–February 6, 2022 #
Anomaly report: mm7107e1. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Discussion): “V-safe does not capture diagnoses associated with hospitalization; however, registrants can include supplemental text for each health check-in.” Paper: “All registrants who indicated that medical care was sought after vaccination were contacted and encouraged to complete a VAERS report.” Same framing for hospitalization reporters. |
|
mm7008e3 — First Month of COVID-19 Vaccine Safety Monitoring — United States, December 14, 2020–January 13, 2021 #
Anomaly report: mm7008e3. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Methods): “Enrollees who report seeking medical care are contacted, and a VAERS report is completed if clinically indicated.” Paper (v-safe Results): publish only reactogenicity frequencies (Figure / Table 2)—no hospitalization or medical-care tallies from v-safe. Paper (Methods): “Enrollees who report seeking medical care are contacted, and a VAERS report is completed if clinically indicated.” |
|
mm7018e2 — Safety Monitoring of the Janssen (Johnson & Johnson) COVID-19 Vaccine — United States, March–April 2021 #
Anomaly report: mm7018e2. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (v-safe Results): “Only 1.4% of enrollees reported seeking any form of medical care in the 7 days after vaccination.” — with no v-safe discussion of clotting codes, TTS-like free text, or deaths. Paper (Methods): “Enrollees who report seeking medical care are contacted by CDC’s v-safe call center and encouraged to complete a VAERS report, if indicated.” Paper (Table 3): reports a small hospitalization percentage after Janssen (about 0.04% of enrollees). |
|
mm7039e4 — Safety Monitoring of an Additional Dose of COVID-19 Vaccine — United States, August 12–September 19, 2021 #
Anomaly report: mm7039e4. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Results): “Medical care was sought by 401 (1.8%) registrants, and thirteen (0.1%) were hospitalized. Reasons for receiving medical care or hospitalization were not identified in the v-safe survey; however, registrants who indicate that medical attention was sought after vaccination are contacted by VAERS staff and encouraged to complete a VAERS report.” |
|
mm7135a3 — COVID-19 mRNA Vaccine Safety Among Children Aged 6 Months–5 Years — United States, June 18–August 21, 2022 #
Anomaly report: mm7135a3. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Results): “Approximately 741 (2%) reported seeking medical care in the week after either dose… Four children received care at a hospital after vaccination; two respondents indicated the hospitalization was unrelated to vaccination, one was unwilling to provide further information, and one completed a VAERS report…” Paper (Results): “Four children received care at a hospital after vaccination; two respondents indicated the hospitalization was unrelated to vaccination, one was unwilling to provide further information, and one completed a VAERS report (Table 3).” Paper (Methods): Call center contacts registrants who indicate medical care was received after vaccination and encourages a VAERS report. |
|
mm7130a4 — Safety Monitoring of COVID-19 mRNA Vaccine Second Booster Doses Among Adults Aged ≥50 Years — United States, March 29–July 10, 2022 #
Anomaly report: mm7130a4. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Results): “Hospitalization was reported by 81 (0.03%) registrants; 39 (48.1%) indicated that the hospitalization was unrelated to vaccination, 28 (34.6%) were unreachable or unwilling to provide additional information, and 14 (17.3%) completed a VAERS report.” Paper (Methods): “CDC’s v-safe call center contacts registrants who indicate that medical care was sought after vaccination and encourages completion of a VAERS report, if indicated.” Paper (Results): of 81 hospitalizations, 28 (34.6%) were unreachable or unwilling. |
|
mm7128a3 — Safety Monitoring of COVID-19 mRNA Vaccine First Booster Doses Among Persons Aged ≥12 Years With Presumed Immunocompromise Status — United States, January 12–March 28, 2022 #
Anomaly report: mm7128a3. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Results): “Two registrants reported receiving care at a hospital during the week after dose 4 vaccination. The v-safe call center contacted both these registrants; one completed a VAERS report, and the other indicated the report was accidental or unrelated to vaccination.” Paper (Results): both hospital reporters “were contacted”; one completed VAERS; the other said the report was accidental/unrelated. Paper (Methods): “CDC’s v-safe call center contacts registrants who indicate that medical care was sought after vaccination and encourages completion of a VAERS report, if indicated.” |
|
mm7223a2 — Safety Monitoring of mRNA COVID-19 Vaccine Third Doses Among Children Aged 6 Months–5 Years — United States, June 17, 2022–May 7, 2023 #
Anomaly report: mm7223a2. Left: MMWR wording. Right: under-coded registrant rows from the v-safe dataset (viewer links).
| MMWR verbatim | Registrant examples |
|---|---|
Paper (Results): “90 (3.0%) parents reported seeking medical care for their child. Among these… one child was hospitalized for pneumonia; 43 (48.0%) had additional information available from the v-safe call center. Parents of 30 children indicated that medical care was unrelated to vaccination, 11 parents completed a VAERS report, and two parents indicated that the report was made in error.” Paper (Results / Table 1): Hospitalization = 1 (0.03%); prose: “one child was hospitalized for pneumonia.” Paper (Results): Of those with call-center information, 30 said medical care was unrelated, 11 completed VAERS, 2 said the report was in error. Infection signs in 34 of 90 medical-care reports. |
|
Searchable evidence grid #
All under-coded hospital rows in this extract (DataTables + SearchBuilder).