DXE-28383-98704
1 vaccination
2 coded responses
8 check-ins
2 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 850 / AZ
- Registered
- 2022-07-04
- Relationship
- Child or adolescent in my care
- Guardian
- KJC-24815-09611
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-29
Dose 1 — Moderna
-
2022-07-04
Registered in v-safe
-
2022-07-04
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Cough, Respiratory tract congestion — Feeling: Poor · Fever · Chills, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Cough and congestionMedDRA releases: 2024-11 · check-in free text available
-
2022-07-06
Survey response — day 7, dose 1, dependentMedDRA: Bronchial hyperreactivity, Ear infection — Feeling: Fair · Fever · Be unable to work or attend schoolFree text: Ear infection, reactive airway diseaseMedDRA releases: 2024-11 · check-in free text available
- 2022-07-16
- 2022-07-20
- 2022-07-27
- 2022-08-05
- 2022-09-30
- 2022-12-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-29 | Moderna | No |
Free text
Release 12 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Cough and congestion
Release 12 — day 7, dose 1, dependent
Systemic reaction (other): Ear infection, reactive airway disease
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 |
|---|---|---|---|---|
| SRO | Bronchial hyperreactivity | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Ear infection | · | · | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release