A5Z-33890-81734
1 vaccination
1 coded response
8 check-ins
1 free-text entry
0 call cases
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 118 / NY
- Registered
- 2022-06-28
- Relationship
- Child or adolescent in my care
- Guardian
- RHP-55393-44560
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-24
Dose 1 — Moderna
-
2022-06-28
Registered in v-safe
- 2022-06-28
- 2022-06-30
- 2022-07-01
- 2022-07-08
-
2022-07-18
Survey response — day 21, dose 1, under 3MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain, Pyrexia, Rash, Respiratory tract congestion, Rhinorrhoea, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Cold symptoms, fever sore throat rash cough congestion sneeze runny noseMedDRA releases: 2024-11 · check-in free text available
- 2022-07-22
- 2022-08-07
- 2022-09-25
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-24 | Moderna | No |
Free text
Release 12 (Under 3) — day 21, dose 1, under 3
Symptoms: Cold symptoms, fever sore throat rash cough congestion sneeze 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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Cough | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release