4TN-20478-75913
3 vaccinations
4 coded responses
38 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 125 / NY
- Registered
- 2022-06-27
- Relationship
- Child or adolescent in my care
- Guardian
- 7LD-19224-70777
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-27
Registered in v-safe
-
2022-06-27
Dose 1 — Moderna
-
2022-06-27
Health check-in — day 0, dose 1, under 3Feeling: Poor · Site: Pain · Sleepiness, Irritability/crying · Be unable to do your normal daily activitiesUnder 3 check-in
- 2022-06-28
- 2022-06-29
- 2022-06-30
- 2022-07-01
- 2022-07-02
- 2022-07-03
- 2022-07-04
-
2022-07-11
Survey response — day 14, dose 1, under 3MedDRA: Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Hives on her feet. Unsure what caused. Continued to worsen for several days. Doctor prescribed steroids.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-11
Report sent to call center — day 14, dose 1, under 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-07-12
Call successfulDoes not wish to fill out VAERS report
- 2022-07-18
-
2022-07-25
Dose 2 — Moderna
- 2022-07-25
-
2022-07-26
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Good · Site: Pain, Redness · Irritability/cryingUnder 3 check-in
- 2022-07-28
- 2022-07-29
- 2022-07-30
- 2022-07-31
- 2022-08-01
- 2022-08-08
- 2022-08-15
-
2022-08-22
Survey response — day 28, dose 2, under 3MedDRA: Reaction to previous exposure to any vaccine, Urticaria — Feeling: GoodFree text: Idk if it relates - within 2 weeks of first shot, she got unexplained hives. Now it's 4 weeks after the second shot and she has explained hives again.MedDRA releases: 2024-11 · check-in free text available
- 2022-08-29
- 2022-09-05
- 2022-10-24
- 2023-01-23
-
2023-02-08
Dose 3 — Moderna
- 2023-02-08
-
2023-02-09
Health check-in — days 1–6 daily, dose 3, under 3Feeling: Good · Site: Redness, Swelling/hardness · NoneUnder 3 check-in
- 2023-02-10
-
2023-02-11
Health check-in — days 1–6 daily, dose 3, under 3Feeling: Good · Sleepiness, Irritability/cryingUnder 3 check-in
- 2023-02-12
- 2023-02-13
- 2023-02-14
- 2023-02-15
- 2023-02-23
-
2023-03-01
Survey response — day 21, dose 3, under 3MedDRA: Nasopharyngitis — Feeling: FairMedDRA releases: 2024-11
- 2023-03-08
- 2023-03-15
-
2023-03-22
Survey response — day 42, dose 3, under 3MedDRA: Constipation — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-05-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-27 | Moderna | No |
| 2 | 2022-07-25 | Moderna | No |
| 3 | 2023-02-08 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-07-11 | Successful 2022-07-12 |
Does not wish to fill out VAERS report |
Free text
Release 12 (Under 3) — day 14, dose 1, under 3
Symptoms: Hives on her feet. Unsure what caused. Continued to worsen for several days. Doctor prescribed steroids.
Release 12 (Under 3) — day 28, dose 2, under 3
Symptoms: Idk if it relates - within 2 weeks of first shot, she got unexplained hives. Now it's 4 weeks after the second shot and she has explained hives again.
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 | Constipation | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release