RSX-27961-95927
2 vaccinations
2 coded responses
17 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 212 / MD
- Registered
- 2022-07-11
- Relationship
- Child or adolescent in my care
- Guardian
- 6GW-55801-81965
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-28
Dose 1 — Moderna
-
2022-07-11
Registered in v-safe
- 2022-07-11
- 2022-07-12
- 2022-07-19
-
2022-07-26
Dose 2 — Moderna
-
2022-07-27
Survey response — days 1–6 daily, dose 2, under 3MedDRA: Rhinorrhoea — Feeling: Fair · Sleepiness, Loss of appetiteFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
-
2022-07-28
Health check-in — days 1–6 daily, dose 2, under 3Feeling: Fair · Fever · Sleepiness, Loss of appetiteUnder 3 check-in
- 2022-07-29
- 2022-07-30
- 2022-07-31
- 2022-08-01
- 2022-08-02
- 2022-08-09
- 2022-08-16
-
2022-08-23
Survey response — day 28, dose 2, under 3MedDRA: Croup infectious, Viral infection — Feeling: Poor · 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 visit, Emergency room or emergency department visitFree text: Croup, virus, not related to COVIDMedDRA releases: 2024-11 · check-in free text available
-
2022-08-23
Report sent to call center — day 28, dose 2, 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 · Emergency room or emergency department visit · 1 call case(s)
-
2022-08-24
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-09-01
- 2022-09-06
- 2022-10-27
- 2023-01-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-28 | Moderna | No |
| 2 | 2022-07-26 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-08-23 | Successful 2022-08-24 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 12 (Under 3) — days 1–6 daily, dose 2, under 3
Systemic reaction (other): Runny nose
Release 12 (Under 3) — day 28, dose 2, under 3
Symptoms: Croup, virus, not related to COVID
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 | Croup infectious | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release