SJ5-16021-82848
2 vaccinations
6 coded responses
14 check-ins
5 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 100 / NY
- Registered
- 2022-10-22
- Relationship
- Child or adolescent in my care
- Guardian
- WV2-17986-12884
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-10-07
Dose 1 — Moderna
-
2022-10-22
Registered in v-safe
- 2022-10-22
- 2022-10-30
-
2022-11-04
Survey response — day 28, dose 1, under 3MedDRA: Viral infection — Feeling: PoorFree text: Viral infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-11-11
Survey response — day 35, dose 1, under 3MedDRA: Viral infection — Feeling: FairFree text: Continued viral infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-11-18
Dose 2 — Moderna
- 2022-11-20
- 2022-11-21
-
2022-11-25
Survey response — day 7, dose 2, under 3MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2022-12-02
Survey response — day 14, dose 2, under 3MedDRA: COVID-19 — Feeling: FairFree text: COVID infectionMedDRA releases: 2024-11 · check-in free text available
- 2022-12-09
- 2022-12-16
- 2022-12-23
-
2022-12-30
Survey response — day 42, dose 2, under 3MedDRA: Body height decreased — Feeling: GoodFree text: Significant drop on height growth chart at routine checkup from 6 to 9 months.MedDRA releases: 2024-11 · check-in free text available
-
2023-02-17
Survey response — 3 months, dose 2, under 3MedDRA: Respiratory tract infection — Feeling: GoodMedDRA releases: 2024-11
- 2023-05-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-10-07 | Moderna | No |
| 2 | 2022-11-18 | Moderna | No |
Free text
Release 12 (Under 3) — day 28, dose 1, under 3
Symptoms: Viral infection
Release 12 (Under 3) — day 35, dose 1, under 3
Symptoms: Continued viral infection
Release 12 (Under 3) — day 7, dose 2, under 3
Systemic reaction (other): No
Release 12 (Under 3) — day 14, dose 2, under 3
Symptoms: COVID infection
Release 12 (Under 3) — day 42, dose 2, under 3
Symptoms: Significant drop on height growth chart at routine checkup from 6 to 9 months.
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 | Body height decreased | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Respiratory tract infection | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release