3XG-26740-16961
3 vaccinations
4 coded responses
28 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 017 / MA
- Registered
- 2022-09-13
- Relationship
- Child or adolescent in my care
- Guardian
- 6V2-22215-96824
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-09-12
Dose 1 — Moderna
-
2022-09-13
Registered in v-safe
-
2022-09-16
Survey response — days 1–6 daily, dose 1, under 3MedDRA: Rash — Feeling: Fair · Irritability/crying, Diarrhea · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Rash developed on 9/14/22, cleared up today. Doctor thinks unrelated to vaccine.MedDRA releases: 2024-11 · check-in free text available
-
2022-09-16
Report sent to call center — days 1–6 daily, dose 1, 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)
- 2022-09-17
- 2022-09-18
- 2022-09-19
-
2022-09-19
Call successfulNot applicable - Accidental Reporting
-
2022-09-26
Survey response — day 14, dose 1, under 3MedDRA: COVID-19, Cough, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend schoolFree text: Runny nose, cough (from a cold - she tested negative for covid via PCR covid test at daycare on 9/21/22)MedDRA releases: 2024-11 · check-in free text available
- 2022-10-03
- 2022-10-10
-
2022-10-14
Dose 2 — Moderna
-
2022-10-14
Health check-in — day 0, dose 2, under 3Feeling: Fair · Site: Pain, Redness · Fever · NoneUnder 3 check-in
-
2022-10-15
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Good · Site: Pain · NoneUnder 3 check-in
- 2022-10-16
- 2022-10-17
- 2022-10-18
- 2022-10-19
- 2022-10-20
- 2022-10-21
-
2022-10-28
Survey response — day 14, dose 2, under 3MedDRA: Ear infection — Feeling: Good · Be unable to work or attend schoolFree text: Ear infection (unrelated to vaccine because a sibling also has a history of ear infections)MedDRA releases: 2024-11 · check-in free text available
- 2022-11-04
- 2022-11-11
-
2022-11-19
Survey response — day 35, dose 2, under 3MedDRA: Diarrhoea, Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend schoolFree text: Cold symptoms, diarrhea - negative for covid per pcr testMedDRA releases: 2024-11 · check-in free text available
- 2022-11-25
- 2023-01-13
-
2023-03-13
Dose 3 — ModernaCo-administered: MMR
- 2023-03-24
- 2023-03-27
- 2023-04-03
- 2023-04-10
- 2023-04-17
- 2023-04-24
- 2023-06-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-09-12 | Moderna | No |
| 2 | 2022-10-14 | Moderna | No |
| 3 | 2023-03-13 | Moderna | MMR |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-09-16 | Successful 2022-09-19 |
Not applicable - Accidental Reporting |
Free text
Release 12 (Under 3) — days 1–6 daily, dose 1, under 3
Systemic reaction (other): Rash developed on 9/14/22, cleared up today. Doctor thinks unrelated to vaccine.
Release 12 (Under 3) — day 14, dose 1, under 3
Symptoms: Runny nose, cough (from a cold - she tested negative for covid via PCR covid test at daycare on 9/21/22)
Release 12 (Under 3) — day 14, dose 2, under 3
Symptoms: Ear infection (unrelated to vaccine because a sibling also has a history of ear infections)
Release 12 (Under 3) — day 35, dose 2, under 3
Symptoms: Cold symptoms, diarrhea - negative for covid per pcr test
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 | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release