5LA-14959-28009
3 vaccinations
3 coded responses
24 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 981 / WA
- Registered
- 2022-08-18
- Relationship
- Child or adolescent in my care
- Guardian
- GCH-97770-86689
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-08-18
Registered in v-safe
-
2022-08-18
Dose 1 — Moderna
- 2022-08-18
- 2022-08-20
- 2022-08-21
- 2022-08-22
- 2022-08-23
- 2022-08-24
- 2022-08-25
- 2022-09-01
-
2022-09-08
Survey response — day 21, dose 1, under 3MedDRA: Pyrexia, Rhinorrhoea — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Fever, runny noseMedDRA releases: 2024-11 · check-in free text available
-
2022-09-15
Dose 2 — Moderna
-
2022-09-16
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Site: Pain · Fever · Irritability/cryingUnder 3 check-in
- 2022-09-17
-
2022-09-18
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Site: Pain · Irritability/crying · Be unable to do your normal daily activitiesUnder 3 check-in
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-24
- 2022-09-29
-
2022-10-06
Survey response — day 21, dose 2, under 3MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Congestion, sore throatMedDRA releases: 2024-11 · check-in free text available
-
2022-10-13
Survey response — day 28, dose 2, under 3MedDRA: Anaphylaxis treatment, Croup infectious, Emergency care, Respiratory distress — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Respiratory distress from croup, needed racenic epinephrine in the ER. Tested, not COVIDMedDRA releases: 2024-11 · check-in free text available
-
2022-10-13
Report sent to call center — day 28, dose 2, under 3Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2022-10-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-20
- 2022-10-29
- 2022-12-15
-
2023-02-10
Dose 3 — Moderna
- 2023-03-16
- 2023-05-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-08-18 | Moderna | No |
| 2 | 2022-09-15 | Moderna | No |
| 3 | 2023-02-10 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 12 (Under 3) — day 21, dose 1, under 3
Symptoms: Fever, runny nose
Release 12 (Under 3) — day 21, dose 2, under 3
Symptoms: Congestion, sore throat
Release 12 (Under 3) — day 28, dose 2, under 3
Symptoms: Respiratory distress from croup, needed racenic epinephrine in the ER. Tested, not COVID
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 | Anaphylaxis treatment | · | · | ✓ |
| SD | Croup infectious | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory distress | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release