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9BK-29877-16267

1 vaccination 5 coded responses 12 check-ins 5 free-text entries 0 call cases
Sex
Male
Age at first dose
0-4
ZIP prefix
981 / WA
Registered
2022-06-24
Relationship
Child or adolescent in my care
Guardian
SUD-91408-36197
Race
Multiracial
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2022-06-24
    Registered in v-safe
  2. 2022-06-25
    Dose 1 — Moderna
  3. 2022-06-25
    Health check-in — day 0, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  4. 2022-06-26
    Survey response — days 1–6 daily, dose 1, under 3
    MedDRA: Rhinorrhoea — Feeling: Fair · Fever
    Free text: Runny nose
    MedDRA releases: 2024-11 · check-in free text available
  5. 2022-06-27
    Survey response — days 1–6 daily, dose 1, under 3
    MedDRA: Rhinorrhoea — Feeling: Fair
    Free text: Runny nose
    MedDRA releases: 2024-11 · check-in free text available
  6. 2022-06-28
    Survey response — days 1–6 daily, dose 1, under 3
    MedDRA: Conjunctivitis, Ear pain, Respiratory tract congestion — Feeling: Poor · Sleepiness, Irritability/crying · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Unrelated to vaccine- conjunctivitis, congestion, ear pain
    MedDRA releases: 2024-11 · check-in free text available
  7. 2022-06-29
    Survey response — days 1–6 daily, dose 1, under 3
    MedDRA: Conjunctivitis, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Sleepiness, Irritability/crying · Be unable to work or attend school
    Free text: Conjunctivitis and congestion and runny nose
    MedDRA releases: 2024-11 · check-in free text available
  8. 2022-07-01
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Fair · Sleepiness · Be unable to work or attend school
    Under 3 check-in
  9. 2022-07-04
    Health check-in — day 7, dose 1, under 3
    Feeling: Fair · Sleepiness · Be unable to work or attend school
    Under 3 check-in
  10. 2022-07-11
    Health check-in — day 14, dose 1, under 3
    Feeling: Fair
    Under 3 check-in
  11. 2022-07-16
    Health check-in — day 21, dose 1, under 3
    Feeling: Good
    Under 3 check-in
  12. 2022-09-24
    Health check-in — 3 months, dose 1, under 3
    Feeling: Good
    Under 3 check-in
  13. 2022-12-24
    Health check-in — 6 months, dose 1, under 3
    Feeling: Good
    Free text: Coughing, runny nose
    Under 3 check-in · check-in free text available
  14. 2023-06-27
    Survey response — 12 months, dose 1, under 3
    MedDRA: Nasopharyngitis — Feeling: Good
    MedDRA releases: 2024-11

Vaccinations

DoseDateManufacturerCo-administered
12022-06-25Moderna No

Free text

Release 12 (Under 3) — days 1–6 daily, dose 1, under 3

2022-06-26

Systemic reaction (other): Runny nose

2022-06-27

Systemic reaction (other): Runny nose

2022-06-28

Systemic reaction (other): Unrelated to vaccine- conjunctivitis, congestion, ear pain

2022-06-29

Systemic reaction (other): Conjunctivitis and congestion and runny nose

Release 12 (Under 3) — 6 months, dose 1, under 3

2022-12-24

Symptoms: Coughing, runny nose

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
SDNasopharyngitis · · ✓
SROConjunctivitis · · ✓
SROEar pain · · ✓
SRORespiratory tract congestion · · ✓
SRORhinorrhoea · · ✓

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