Q4Z-23837-74206

1 vaccination 1 coded response 3 check-ins 1 free-text entry 0 call cases

Sex: Male
Age at first dose: 0-4
ZIP prefix: 322 / FL
Registered: 2022-06-29

Relationship: Child or adolescent in my care
Guardian: QFL-29885-92388
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2022-06-22
Dose 1 — Moderna
2022-06-29
Registered in v-safe
2022-06-29
Survey response — day 7, dose 1, dependent
MedDRA: Adverse reaction — Feeling: Fair · Fever · Abdominal pain

Free text: Mild

MedDRA releases: 2024-11 · check-in free text available
2022-07-16
Health check-in — day 21, dose 1, dependent
Feeling: Good

Adult check-in
2022-07-27
Health check-in — day 35, dose 1, dependent
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2022-06-22	Moderna	No

Free text

Release 12 — day 7, dose 1, dependent

2022-06-29

Systemic reaction (other): Mild

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
SRO	Adverse reaction	·	·	✓

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