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LWD-24948-04963

1 vaccination 3 coded responses 12 check-ins 3 free-text entries 0 call cases
Sex
Female
Age at first dose
0-4
ZIP prefix
435 / OH
Registered
2022-06-23
Relationship
Child or adolescent in my care
Guardian
UUW-28665-51345
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2022-06-23
    Registered in v-safe
  2. 2022-06-23
    Dose 1 — Moderna
  3. 2022-06-23
    Health check-in — day 0, dose 1, dependent
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2022-06-24
    Survey response — days 1–6 daily, dose 1, dependent
    MedDRA: Irritability — Feeling: Good · Site: Pain
    Free text: Irritability (mild)
    MedDRA releases: 2024-11 · check-in free text available
  5. 2022-06-26
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  6. 2022-06-27
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  7. 2022-06-28
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  8. 2022-07-02
    Health check-in — day 7, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  9. 2022-07-07
    Health check-in — day 14, dose 1, dependent
    Feeling: Good
    Adult check-in
  10. 2022-07-14
    Health check-in — day 21, dose 1, dependent
    Feeling: Good
    Adult check-in
  11. 2022-07-21
    Survey response — day 28, dose 1, dependent
    MedDRA: Von Willebrand's disease — Feeling: Good
    Free text: Diagnosed with low von willebrand factor (unrelated to vaccine)
    MedDRA releases: 2024-11 · check-in free text available
  12. 2022-09-22
    Survey response — 3 months, dose 1, dependent
    MedDRA: Von Willebrand's disease — Feeling: Good
    Free text: Diagnosed with Von Willebrand Disease (unrelated to vaccine)
    MedDRA releases: 2024-11 · check-in free text available
  13. 2022-12-22
  14. 2023-06-23

Vaccinations

DoseDateManufacturerCo-administered
12022-06-23Moderna No

Free text

Release 12 — days 1–6 daily, dose 1, dependent

2022-06-24

Systemic reaction (other): Irritability (mild)

Release 12 — day 28, dose 1, dependent

2022-07-21

Symptoms: Diagnosed with low von willebrand factor (unrelated to vaccine)

Release 12 — 3 months, dose 1, dependent

2022-09-22

Symptoms: Diagnosed with Von Willebrand Disease (unrelated to vaccine)

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

FieldPreferred term2021-092023-042024-11
SDVon Willebrand's disease · · ✓
SROIrritability · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release