3NQ-17206-85508
2 vaccinations
3 coded responses
15 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 604 / IL
- Registered
- 2022-06-21
- Relationship
- Child or adolescent in my care
- Guardian
- 47V-96050-31725
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-21
Registered in v-safe
-
2022-06-28
Dose 1 — Moderna
- 2022-06-29
- 2022-06-30
- 2022-07-02
- 2022-07-04
- 2022-07-05
- 2022-07-12
-
2022-07-19
Survey response — day 21, dose 1, dependentMedDRA: Abdominal pain, Gastrointestinal disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: GI symptoms, with persistent cramps in lower left abdomen. I do not suspect a relationship with the booster. Suspect diverticulitis and will be seeking medical advice today. Selections will reflect the anticipated outpatient visit.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-19
Report sent to call center — day 21, dose 1, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-07-20
-
2022-07-26
Dose 2 — Moderna
- 2022-08-02
- 2022-08-10
-
2022-08-16
Survey response — day 21, dose 2, dependentMedDRA: Cough, Exposure to SARS-CoV-2, Pyrexia, Respiratory tract congestion, Suspected COVID-19 — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Dry cough, congestion, fever. Covid virtually certain. Untested, but family member has covid confrimed by home tests.MedDRA releases: 2024-11 · check-in free text available
-
2022-08-16
Report sent to call center — day 21, dose 2, dependentBe unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-08-17
Call successfulParticipant prefers to complete VAERS report online
- 2022-08-23
- 2022-08-30
-
2022-09-06
Survey response — day 42, dose 2, dependentMedDRA: Abdominal pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Tummy ache. Likely related to too much candy and ice cream over the weekend.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-26
- 2023-01-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-28 | Moderna | No |
| 2 | 2022-07-26 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 12 — day 21, dose 1, dependent
Symptoms: GI symptoms, with persistent cramps in lower left abdomen. I do not suspect a relationship with the booster. Suspect diverticulitis and will be seeking medical advice today. Selections will reflect the anticipated outpatient visit.
Release 12 — day 21, dose 2, dependent
Symptoms: Dry cough, congestion, fever. Covid virtually certain. Untested, but family member has covid confrimed by home tests.
Release 12 — day 42, dose 2, dependent
Symptoms: Tummy ache. Likely related to too much candy and ice cream over the weekend.
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 | Abdominal pain | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Suspected COVID-19 | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release