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4T2-29628-09671

1 vaccination 5 coded responses 11 check-ins 6 free-text entries 0 call cases
Sex
Female
Age at first dose
0-4
ZIP prefix
544 / WI
Registered
2022-06-28
Relationship
Child or adolescent in my care
Guardian
4YC-13301-87689
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2022-06-25
    Dose 1 — Moderna
  2. 2022-06-28
    Registered in v-safe
  3. 2022-06-28
    Survey response — days 1–6 daily, dose 1, dependent
    MedDRA: Injection site pain — Feeling: Good
    Free text: She's saying her injection site is sore and hasn't let me change her dress for 3 days, but is otherwise her joyful, active, good-humored self! Thank you for approving vaccine for our kidlets!!
    MedDRA releases: 2024-11 · check-in free text available
  4. 2022-06-29
    Survey response — days 1–6 daily, dose 1, dependent
    MedDRA: Unevaluable event — Feeling: Good
    Free text: Left deltoid no tender, no swelling
    MedDRA releases: 2024-11 · check-in free text available
  5. 2022-06-30
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  6. 2022-07-01
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  7. 2022-07-02
    Survey response — day 7, dose 1, dependent
    MedDRA: Irritability — Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Irritable, won't let me take her temperature
    MedDRA releases: 2024-11 · check-in free text available
  8. 2022-07-09
    Survey response — day 14, dose 1, dependent
    MedDRA: Pyrexia, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities
    Free text: She developed PCR confirmed Covid just over a week ago. Initially thought her fever was vaccine related. PCR test done 7/7
    MedDRA releases: 2024-11 · check-in free text available
  9. 2022-07-16
    Survey response — day 21, dose 1, dependent
    MedDRA: COVID-19 — Feeling: Good
    Free text: Recovered from bout of Covid in early July
    MedDRA releases: 2024-11 · check-in free text available
  10. 2022-07-23
    Health check-in — day 28, dose 1, dependent
    Feeling: Good
    Adult check-in
  11. 2022-09-24
  12. 2022-12-24
    Health check-in — 6 months, dose 1, dependent
    Feeling: Good · Be unable to work or attend school
    Free text: 5 day respiratory infection starting 12/8. Self-limited, Covid testing x2 negative
    Adult check-in · check-in free text available
  13. 2023-06-25

Vaccinations

DoseDateManufacturerCo-administered
12022-06-25Moderna No

Free text

Release 12 — days 1–6 daily, dose 1, dependent

2022-06-28

Systemic reaction (other): She's saying her injection site is sore and hasn't let me change her dress for 3 days, but is otherwise her joyful, active, good-humored self! Thank you for approving vaccine for our kidlets!!

2022-06-29

Systemic reaction (other): Left deltoid no tender, no swelling

Release 12 — day 7, dose 1, dependent

2022-07-02

Systemic reaction (other): Irritable, won't let me take her temperature

Release 12 — day 14, dose 1, dependent

2022-07-09

Symptoms: She developed PCR confirmed Covid just over a week ago. Initially thought her fever was vaccine related. PCR test done 7/7

Release 12 — day 21, dose 1, dependent

2022-07-16

Symptoms: Recovered from bout of Covid in early July

Release 12 — 6 months, dose 1, dependent

2022-12-24

Symptoms: 5 day respiratory infection starting 12/8. Self-limited, Covid testing x2 negative

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

FieldPreferred term2021-092023-042024-11
SDCOVID-19 · · ✓
SDPyrexia · · ✓
SDSARS-CoV-2 test positive · · ✓
SROInjection site pain · · ✓
SROIrritability · · ✓
SROUnevaluable event · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release