S4Q-22971-00975
1 vaccination
1 coded response
13 check-ins
1 free-text entry
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 980 / WA
- Registered
- 2022-07-11
- Relationship
- Child or adolescent in my care
- Guardian
- X7Z-15701-36350
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-07-10
Dose 1 — Moderna
-
2022-07-11
Registered in v-safe
-
2022-07-11
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Poor · Site: Redness · Fever · Sleepiness, Irritability/crying, Loss of appetite · Be unable to work or attend schoolUnder 3 check-in
-
2022-07-12
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Fair · Fever · Irritability/crying, Rash, not including the immediate area around the injection site · Be unable to work or attend schoolUnder 3 check-in
-
2022-07-14
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Good · Fever · Sleepiness, Rash, not including the immediate area around the injection siteUnder 3 check-in
- 2022-07-15
- 2022-07-16
- 2022-07-17
- 2022-07-26
-
2022-07-31
Survey response — day 21, dose 1, under 3MedDRA: COVID-19, Croup infectious, Immunisation reaction, Respiratory distress — 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 visit, Emergency room or emergency department visit, HospitalizationFree text: Covid, Covid croup, respiratory distressMedDRA releases: 2024-11 · check-in free text available
-
2022-07-31
Report sent to call center — day 21, dose 1, 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 · Hospitalization · 1 call case(s)
- 2022-08-01
-
2022-08-01
Call successfulDoes not wish to fill out VAERS report
- 2022-08-07
- 2022-08-14
- 2022-08-21
- 2022-10-09
- 2023-01-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-07-10 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-07-31 | Successful 2022-08-01 |
Does not wish to fill out VAERS report |
Free text
Release 12 (Under 3) — day 21, dose 1, under 3
Symptoms: Covid, Covid croup, respiratory distress
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 | COVID-19 | · | · | ✓ |
| SD | Croup infectious | · | · | ✓ |
| SD | Immunisation reaction | · | · | ✓ |
| SD | Respiratory distress | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release