25M-28791-99192
3 vaccinations
5 coded responses
39 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 802 / CO
- Registered
- 2022-06-22
- Relationship
- Child or adolescent in my care
- Guardian
- 375-24939-21069
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-22
Registered in v-safe
-
2022-06-22
Dose 1 — Moderna
- 2022-06-22
-
2022-06-23
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-06-24
- 2022-06-25
- 2022-06-26
- 2022-06-27
- 2022-06-28
- 2022-06-29
- 2022-07-06
- 2022-07-13
- 2022-07-20
- 2022-07-27
-
2022-08-03
Dose 2 — Moderna
-
2022-08-03
Health check-in — day 0, dose 2, dependentFeeling: Fair · Site: Pain · None · Be unable to work or attend schoolAdult check-in
-
2022-08-04
Survey response — days 1–6 daily, dose 2, dependentMedDRA: Irritability — Feeling: Poor · Site: Pain · Fever · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: FussinessMedDRA releases: 2024-11 · check-in free text available
-
2022-08-05
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Fatigue or tirednessAdult check-in
- 2022-08-06
- 2022-08-07
- 2022-08-08
- 2022-08-09
- 2022-08-10
- 2022-08-17
- 2022-08-24
-
2022-08-31
Survey response — day 28, dose 2, dependentMedDRA: Cough, Fatigue, Pyrexia, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Fever, runny nose, fatigue, coughMedDRA releases: 2024-11 · check-in free text available
- 2022-09-09
- 2022-09-14
-
2022-11-02
Survey response — 3 months, dose 2, dependentMedDRA: Cough, Pyrexia, Respiratory disorder, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Multiple non Covid respiratory illnesses. Runny nose, congestion, fever, coughMedDRA releases: 2024-11 · check-in free text available
-
2023-01-05
Dose 3 — Moderna
-
2023-01-06
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Poor · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Vomiting · Be unable to do your normal daily activitiesAdult check-in
- 2023-01-07
- 2023-01-08
- 2023-01-09
- 2023-01-10
- 2023-01-11
- 2023-01-12
-
2023-01-19
Survey response — day 14, dose 3, dependentMedDRA: Fatigue, Headache, Pain, Pyrexia — Feeling: Poor · 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
-
2023-01-19
Report sent to call center — day 14, dose 3, dependentBe unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-01-20
Call successfulDoes not wish to fill out VAERS report
- 2023-01-26
- 2023-02-02
-
2023-02-09
Survey response — day 35, dose 3, dependentMedDRA: Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-02-16
- 2023-04-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-22 | Moderna | No |
| 2 | 2022-08-03 | Moderna | No |
| 3 | 2023-01-05 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 12 — days 1–6 daily, dose 2, dependent
Systemic reaction (other): Fussiness
Release 12 — day 28, dose 2, dependent
Symptoms: Fever, runny nose, fatigue, cough
Release 12 — 3 months, dose 2, dependent
Symptoms: Multiple non Covid respiratory illnesses. Runny nose, congestion, fever, cough
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 | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Irritability | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release