635-22160-69492
1 vaccination
1 coded response
12 check-ins
0 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 920 / CA
- Registered
- 2022-09-25
- Relationship
- Child or adolescent in my care
- Guardian
- 6UP-26559-87147
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-09-25
Registered in v-safe
-
2022-09-25
Dose 1 — Moderna
- 2022-09-25
- 2022-09-26
- 2022-09-27
- 2022-09-28
- 2022-09-29
- 2022-09-30
- 2022-10-01
- 2022-10-02
- 2022-10-09
- 2022-10-16
- 2022-12-30
-
2023-03-27
Survey response — 6 months, dose 1, under 3MedDRA: COVID-19 — 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 professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-03-27
Report sent to call center — 6 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 prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2023-03-28
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-09-25 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-03-27 | Successful 2023-03-28 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
None.
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 | COVID-19 | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release