9KF-19415-61021
1 vaccination
1 coded response
8 check-ins
1 free-text entry
1 call case
- Sex
- Male
- Age at first dose
- 05-11
- ZIP prefix
- 293 / SC
- Registered
- 2022-06-30
- Relationship
- Child or adolescent in my care
- Guardian
- KLM-18631-40243
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-30
Registered in v-safe
-
2022-07-02
Dose 1 — Moderna
- 2022-07-09
- 2022-07-17
- 2022-07-23
- 2022-07-30
-
2022-08-06
Survey response — day 35, dose 1, dependentMedDRA: Cough, Pyrexia, SARS-CoV-2 test positive — 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 · Telehealth, virtual health, or email health consultationFree text: Tested positive for Covid, fever and coughMedDRA releases: 2024-11 · check-in free text available
-
2022-08-06
Report sent to call center — day 35, dose 1, dependentBe unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-08-08
- 2022-08-13
- 2022-10-03
- 2022-12-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-07-02 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 12 — day 35, dose 1, dependent
Symptoms: Tested positive for Covid, fever and cough
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 | Cough | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release