L9Y-36166-95233
2 vaccinations
6 coded responses
25 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 070 / NJ
- Registered
- 2022-08-05
- Relationship
- Child or adolescent in my care
- Guardian
- 6XE-26398-90617
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-08-04
Dose 1 — Moderna
-
2022-08-05
Registered in v-safe
-
2022-08-05
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-08-06
- 2022-08-07
- 2022-08-08
- 2022-08-09
- 2022-08-10
- 2022-08-11
- 2022-08-18
-
2022-08-25
Survey response — day 21, dose 1, dependentMedDRA: Nausea — Feeling: GoodFree text: Sudden nauseaMedDRA releases: 2024-11 · check-in free text available
-
2022-09-01
Survey response — day 28, dose 1, dependentMedDRA: Pyrexia, Rash — Feeling: Good · Be unable to do your normal daily activitiesFree text: Fever, rashMedDRA releases: 2024-11 · check-in free text available
- 2022-09-08
-
2022-09-16
Dose 2 — Moderna
-
2022-09-17
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-09-18
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-22
-
2022-09-23
Survey response — day 7, dose 2, dependentMedDRA: Respiratory tract congestion — Feeling: GoodFree text: CongestionMedDRA releases: 2024-11 · check-in free text available
- 2022-09-30
- 2022-10-09
-
2022-10-14
Survey response — day 28, dose 2, dependentMedDRA: Diarrhoea, Rhinorrhoea — Feeling: Good · Be unable to work or attend schoolFree text: Runny nose, diarrheaMedDRA releases: 2024-11 · check-in free text available
-
2022-10-21
Survey response — day 35, dose 2, dependentMedDRA: Localised infection, Rash — Feeling: Good · Be unable to work or attend schoolFree text: Infected toe Belly rashMedDRA releases: 2024-11 · check-in free text available
- 2022-10-28
- 2022-12-16
-
2023-03-17
Survey response — 6 months, dose 2, dependentMedDRA: Pyrexia, Rash — 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 · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-03-17
Report sent to call center — 6 months, dose 2, dependentBe 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)
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-08-04 | Moderna | No |
| 2 | 2022-09-16 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-03-17 | Unsuccessful |
Free text
Release 12 — day 21, dose 1, dependent
Symptoms: Sudden nausea
Release 12 — day 28, dose 1, dependent
Symptoms: Fever, rash
Release 12 — day 7, dose 2, dependent
Systemic reaction (other): Congestion
Release 12 — day 28, dose 2, dependent
Symptoms: Runny nose, diarrhea
Release 12 — day 35, dose 2, dependent
Symptoms: Infected toe Belly rash
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 | Diarrhoea | · | · | ✓ |
| SD | Localised infection | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release