N63-12238-62052
3 vaccinations
2 coded responses
36 check-ins
1 free-text entry
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 800 / CO
- Registered
- 2022-06-24
- Relationship
- Child or adolescent in my care
- Guardian
- FBZ-22795-44465
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-23
Dose 1 — Moderna
-
2022-06-24
Registered in v-safe
- 2022-06-24
- 2022-06-25
- 2022-06-26
- 2022-06-27
- 2022-06-29
- 2022-06-30
- 2022-07-07
-
2022-07-14
Survey response — day 21, dose 1, under 3MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: Minor cold symptoms, cough, sore throatMedDRA releases: 2024-11 · check-in free text available
-
2022-07-21
Dose 2 — Moderna
-
2022-07-21
Health check-in — day 0, dose 2, under 3Feeling: Good · Site: Pain, Redness · Fever · Irritability/crying, Loss of appetite · Be unable to do your normal daily activitiesUnder 3 check-in
-
2022-07-22
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Site: Pain · Fever · Sleepiness, Irritability/crying, Loss of appetite · Be unable to do your normal daily activitiesUnder 3 check-in
- 2022-07-23
- 2022-07-24
- 2022-07-25
- 2022-07-26
- 2022-07-27
- 2022-07-28
- 2022-08-04
- 2022-08-11
- 2022-08-20
- 2022-08-29
- 2022-09-03
- 2022-10-22
-
2023-01-05
Dose 3 — Moderna
-
2023-01-05
Health check-in — day 0, dose 3, under 3Feeling: Good · Site: Pain · Irritability/cryingUnder 3 check-in
-
2023-01-06
Health check-in — days 1–6 daily, dose 3, under 3Feeling: Fair · Irritability/crying, Loss of appetiteUnder 3 check-in
-
2023-01-07
Health check-in — days 1–6 daily, dose 3, under 3Feeling: Good · Irritability/cryingUnder 3 check-in
- 2023-01-08
- 2023-01-09
- 2023-01-10
-
2023-01-11
Health check-in — days 1–6 daily, dose 3, under 3Feeling: Good · Irritability/cryingUnder 3 check-in
- 2023-01-12
- 2023-01-19
- 2023-01-26
- 2023-02-04
- 2023-02-09
- 2023-02-16
-
2023-04-06
Survey response — 3 months, dose 3, under 3MedDRA: Gastroenteritis, Nasopharyngitis — 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
-
2023-04-06
Report sent to call center — 3 months, dose 3, 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)
-
2023-04-07
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-23 | Moderna | No |
| 2 | 2022-07-21 | Moderna | No |
| 3 | 2023-01-05 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 12 (Under 3) — day 21, dose 1, under 3
Symptoms: Minor cold symptoms, cough, sore throat
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 | Cough | · | · | ✓ |
| SD | Gastroenteritis | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release