LUU-18216-00352
3 vaccinations
1 coded response
4 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 033 / NH
- Registered
- 2021-07-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
TYY-29139-80656
Child or adolescent in my care · Male · 2022-06-24
5J9-40987-83301
Child or adolescent in my care · Male · 2022-06-24
Timeline
-
2021-04-05
Dose 1 — Moderna
-
2021-05-06
Dose 2 — Moderna
-
2021-07-20
Registered in v-safe
- 2021-08-05
- 2021-11-04
-
2021-11-14
Dose 3 — Moderna
- 2022-05-06
-
2022-11-14
Survey response — 12 months, dose 3MedDRA: COVID-19 — 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 · Telehealth, virtual health, or email health consultationFree text: COVID 11/3MedDRA releases: 2024-11 · check-in free text available
-
2022-11-14
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-11-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-05 | Moderna | No |
| 2 | 2021-05-06 | Moderna | No |
| 3 | 2021-11-14 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 12 — 12 months, dose 3
Symptoms: COVID 11/3
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 | COVID-19 | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release