RQM-31882-15182
1 vaccination
2 coded responses
15 check-ins
1 free-text entry
0 call cases
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 537 / WI
- Registered
- 2022-06-23
- Relationship
- Child or adolescent in my care
- Guardian
- HCJ-91076-10282
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-23
Registered in v-safe
-
2022-07-06
Dose 1 — Moderna
- 2022-07-06
-
2022-07-07
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Fatigue or tirednessAdult check-in
- 2022-07-08
- 2022-07-09
-
2022-07-10
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Fatigue or tirednessAdult check-in
- 2022-07-11
- 2022-07-12
- 2022-07-13
- 2022-07-20
- 2022-07-27
-
2022-08-03
Survey response — day 28, dose 1, dependentMedDRA: Viral upper respiratory tract infection — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Viral URI starting 3 days agoMedDRA releases: 2024-11 · check-in free text available
- 2022-08-10
- 2022-08-17
- 2022-10-05
-
2023-01-04
Survey response — 6 months, dose 1, dependentMedDRA: Influenza, Pre-existing disease, Upper respiratory tract infection — Feeling: Good · Be unable to work or attend schoolMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-07-06 | Moderna | No |
Free text
Release 12 — day 28, dose 1, dependent
Symptoms: Viral URI starting 3 days ago
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 | Influenza | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SD | Viral upper respiratory tract infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release