57Y-29187-87289
1 vaccination
4 coded responses
6 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 551 / MN
- Registered
- 2022-09-23
- Relationship
- Child or adolescent in my care
- Guardian
- X9L-29888-21868
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-09-16
Dose 1 — ModernaCo-administered: Flu:Hepatitis B:Rotavirus:Tetanus
-
2022-09-23
Registered in v-safe
- 2022-09-23
-
2022-09-30
Survey response — day 14, dose 1, under 3MedDRA: Cough, Respiratory tract congestion — Feeling: FairFree text: Nightly cough, congestionMedDRA releases: 2024-11 · check-in free text available
-
2022-10-09
Survey response — day 21, dose 1, under 3MedDRA: Cough, Dyspnoea, Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Fast breathing, cough, congestion, runny noseMedDRA releases: 2024-11 · check-in free text available
-
2022-10-30
Survey response — day 42, dose 1, under 3MedDRA: Cough, Ear discomfort, Eye discharge, Rhinorrhoea — Feeling: PoorFree text: Pulling ears, gunky eyes and nose, coughMedDRA releases: 2024-11 · check-in free text available
-
2022-12-16
Survey response — 3 months, dose 1, under 3MedDRA: Ear infection, Office visit, Pyrexia, Vomiting — 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 professionalFree text: Symptoms: Ear infection, high fever and vomiting · Healthcare visit (other): Primary care docMedDRA releases: 2024-11 · check-in free text available
-
2022-12-16
Report sent to call center — 3 months, dose 1, under 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2022-12-19
- 2023-03-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-09-16 | Moderna | Flu:Hepatitis B:Rotavirus:Tetanus |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-16 | Unsuccessful |
Free text
Release 12 (Under 3) — day 14, dose 1, under 3
Symptoms: Nightly cough, congestion
Release 12 (Under 3) — day 21, dose 1, under 3
Symptoms: Fast breathing, cough, congestion, runny nose
Release 12 (Under 3) — day 42, dose 1, under 3
Symptoms: Pulling ears, gunky eyes and nose, cough
Release 12 (Under 3) — 3 months, dose 1, under 3
Symptoms: Ear infection, high fever and vomiting
Healthcare visit (other): Primary care doc
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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Ear discomfort | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Eye discharge | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release