T5H-16639-89861
3 vaccinations
3 coded responses
26 check-ins
2 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 554 / MN
- Registered
- 2022-06-28
- Relationship
- Child or adolescent in my care
- Guardian
- WP9-96322-76628
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-28
Registered in v-safe
-
2022-06-30
Dose 1 — Moderna
- 2022-07-01
- 2022-07-02
- 2022-07-03
- 2022-07-04
- 2022-07-05
-
2022-07-06
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Nasal congestion — Feeling: GoodFree text: Nasal congestionMedDRA releases: 2024-11 · check-in free text available
- 2022-07-07
- 2022-07-14
- 2022-07-21
-
2022-07-28
Dose 2 — Moderna
- 2022-07-28
-
2022-07-29
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-07-30
- 2022-07-31
- 2022-08-01
- 2022-08-02
- 2022-08-03
- 2022-08-04
- 2022-08-11
- 2022-08-19
- 2022-08-25
- 2022-09-01
- 2022-09-08
-
2022-10-27
Survey response — 3 months, dose 2, dependentMedDRA: Diarrhoea, Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: A few days of vomiting and diarrhea at the beginning of OctoberMedDRA releases: 2024-11 · check-in free text available
-
2023-01-28
Survey response — 6 months, dose 2, dependentMedDRA: Ear infection, Nasopharyngitis — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-01-28
Report sent to call center — 6 months, dose 2, dependentBe unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-01-30
-
2023-03-22
Dose 3 — Moderna
- 2023-05-08
- 2023-06-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-30 | Moderna | No |
| 2 | 2022-07-28 | Moderna | No |
| 3 | 2023-03-22 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-01-28 | Unsuccessful |
Free text
Release 12 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Nasal congestion
Release 12 — 3 months, dose 2, dependent
Symptoms: A few days of vomiting and diarrhea at the beginning of October
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 | Diarrhoea | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release