NLB-70137-59461
2 vaccinations
3 coded responses
22 check-ins
1 free-text entry
0 call cases
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 900 / CA
- Registered
- 2022-12-09
- Relationship
- Child or adolescent in my care
- Guardian
- D6F-33285-83257
- Race
- Multiracial
- Ethnicity
- Hispanic or Latino
Timeline
-
2022-12-09
Registered in v-safe
-
2022-12-09
Dose 1 — Moderna
- 2022-12-09
- 2022-12-11
-
2022-12-12
Survey response — days 1–6 daily, dose 1, under 3MedDRA: Unevaluable event — Feeling: GoodFree text: Was given additional vaccines today: DTaP-IPV/Hib, Hepatitis B, Pediatric/Adolescent Vaccine, Pneumococcal Conjugate 13-Valent (PCV13) Vaccine (AFTER 04/01/2010), Rotavirus, Pentavalent Vaccine, and Influenza, QUAD, Preservative FreeMedDRA releases: 2024-11 · check-in free text available
-
2022-12-13
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Fair · Site: Pain · Fever · Sleepiness, Irritability/cryingUnder 3 check-in
-
2022-12-14
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Fair · Irritability/cryingUnder 3 check-in
- 2022-12-15
- 2022-12-18
- 2022-12-23
- 2022-12-30
-
2023-01-06
Dose 2 — Moderna
-
2023-01-07
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Site: Pain · Sleepiness, Irritability/cryingUnder 3 check-in
- 2023-01-08
-
2023-01-09
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Irritability/cryingUnder 3 check-in
- 2023-01-10
-
2023-01-11
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Site: Pain · Irritability/cryingUnder 3 check-in
-
2023-01-12
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Site: Pain · Irritability/cryingUnder 3 check-in
- 2023-01-13
- 2023-01-22
- 2023-01-27
- 2023-02-04
-
2023-02-10
Survey response — day 35, dose 2, under 3MedDRA: Cough, Nasopharyngitis, Rhinorrhoea — Feeling: FairMedDRA releases: 2024-11
-
2023-02-18
Survey response — day 42, dose 2, under 3MedDRA: Cough, Nasopharyngitis, Rhinorrhoea — Feeling: Fair · Be unable to work or attend schoolMedDRA releases: 2024-11
- 2023-04-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-12-09 | Moderna | No |
| 2 | 2023-01-06 | Moderna | No |
Free text
Release 12 (Under 3) — days 1–6 daily, dose 1, under 3
Systemic reaction (other): Was given additional vaccines today: DTaP-IPV/Hib, Hepatitis B, Pediatric/Adolescent Vaccine, Pneumococcal Conjugate 13-Valent (PCV13) Vaccine (AFTER 04/01/2010), Rotavirus, Pentavalent Vaccine, and Influenza, QUAD, Preservative Free
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 | Nasopharyngitis | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release