A5X-92509-26403
4 vaccinations
1 coded response
23 check-ins
1 free-text entry
0 call cases
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 774 / TX
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- Other
- Ethnicity
- Not Hispanic or Latino
Registered dependents
89Q-19342-96594
Child or adolescent in my care · Male · 2021-11-14
HSY-31132-44735
Child or adolescent in my care · Female · 2021-11-14
VX9-66212-83623
Adult relative or friend · Female · 2021-11-14
Timeline
-
2021-01-16
Dose 1 — Moderna
-
2021-02-13
Dose 2 — Moderna
-
2021-03-11
Registered in v-safe
- 2021-03-11
- 2021-05-17
- 2021-08-14
-
2021-11-14
Dose 3 — Moderna
- 2021-11-14
-
2021-11-17
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-11-18
- 2021-11-19
- 2021-11-20
- 2021-11-24
- 2021-11-29
- 2021-12-05
- 2021-12-15
- 2021-12-28
- 2022-02-13
-
2022-04-07
Dose 4 — Moderna
- 2022-04-19
- 2022-04-22
- 2022-04-28
- 2022-05-06
- 2022-05-15
- 2022-05-19
- 2022-07-07
-
2022-10-08
Survey response — 6 months, dose 4MedDRA: Pre-existing disease — Feeling: GoodFree text: AllergiesMedDRA releases: 2024-11 · check-in free text available
- 2023-04-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Moderna | |
| 2 | 2021-02-13 | Moderna | |
| 3 | 2021-11-14 | Moderna | No |
| 4 | 2022-04-07 | Moderna | No |
Free text
Release 12 — 6 months, dose 4
Symptoms: Allergies
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 | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release