JFJ-27208-39732
1 vaccination
1 coded response
2 check-ins
1 free-text entry
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 602 / IL
- Registered
- 2022-10-05
- Relationship
- Child or adolescent in my care
- Guardian
- LZ3-19588-08510
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-09-24
Dose 1 — Moderna
-
2022-10-05
Registered in v-safe
- 2022-10-05
-
2022-10-10
Survey response — day 14, dose 1, under 3MedDRA: Bronchiolitis, Respiratory syncytial virus infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: rsv, bronchiolitisMedDRA releases: 2024-11 · check-in free text available
-
2022-10-10
Report sent to call center — day 14, dose 1, under 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-10-11
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-09-24 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-10 | Successful 2022-10-11 |
Does not wish to fill out VAERS report |
Free text
Release 12 (Under 3) — day 14, dose 1, under 3
Symptoms: rsv, bronchiolitis
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 | Bronchiolitis | · | · | ✓ |
| SD | Respiratory syncytial virus infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release