33Z-19077-24709
2 vaccinations
1 coded response
2 check-ins
0 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 190 / PA
- Registered
- 2022-10-05
- Relationship
- Child or adolescent in my care
- Guardian
- Z6R-15726-95028
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-07-13
Dose 1 — Moderna
-
2022-08-10
Dose 2 — Moderna
-
2022-10-05
Registered in v-safe
- 2022-11-11
-
2023-02-10
Survey response — 6 months, dose 2, dependentMedDRA: Cough, Nasopharyngitis, Rhinorrhoea — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-02-10
Report sent to call center — 6 months, 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 prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-02-13
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-07-13 | Moderna | No |
| 2 | 2022-08-10 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-02-10 | Successful 2023-02-13 |
Does not wish to fill out VAERS report |
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 | Nasopharyngitis | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release