TQV-12822-25958
3 vaccinations
5 coded responses
18 check-ins
5 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 981 / WA
- Registered
- 2022-07-16
- Relationship
- Child or adolescent in my care
- Guardian
- BP5-34002-10358
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-07-09
Dose 1 — Moderna
-
2022-07-16
Registered in v-safe
- 2022-07-16
- 2022-07-23
-
2022-07-30
Survey response — day 21, dose 1, under 3MedDRA: Gastrointestinal disorder, Pyrexia, Vomiting — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: GI illness x 24 hours. Fever and vomiting x 24 hours.MedDRA releases: 2024-11 · check-in free text available
-
2022-08-06
Dose 2 — Moderna
- 2022-08-06
- 2022-08-07
- 2022-08-08
- 2022-08-09
- 2022-08-10
- 2022-08-11
-
2022-08-12
Survey response — days 1–6 daily, dose 2, under 3MedDRA: Rhinorrhoea — Feeling: GoodFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
-
2022-08-13
Survey response — day 7, dose 2, under 3MedDRA: Cough, Rhinorrhoea — Feeling: GoodFree text: Runny nose, coughingMedDRA releases: 2024-11 · check-in free text available
- 2022-08-20
- 2022-08-27
-
2022-09-03
Survey response — day 28, dose 2, under 3MedDRA: Cough — Feeling: GoodFree text: Slight cough x 2 daysMedDRA releases: 2024-11 · check-in free text available
- 2022-09-10
- 2022-09-18
-
2022-11-05
Survey response — 3 months, dose 2, under 3MedDRA: SARS-CoV-2 test negative, Viral infection — 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 visitFree text: Viral illness x 2, not CovidMedDRA releases: 2024-11 · check-in free text available
-
2022-11-05
Report sent to call center — 3 months, 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)
-
2022-11-07
Call successfulNot applicable - Accidental Reporting
-
2023-01-11
Dose 3 — Moderna
- 2023-02-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-07-09 | Moderna | No |
| 2 | 2022-08-06 | Moderna | No |
| 3 | 2023-01-11 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 12 (Under 3) — day 21, dose 1, under 3
Symptoms: GI illness x 24 hours. Fever and vomiting x 24 hours.
Release 12 (Under 3) — days 1–6 daily, dose 2, under 3
Systemic reaction (other): Runny nose
Release 12 (Under 3) — day 7, dose 2, under 3
Systemic reaction (other): Runny nose, coughing
Release 12 (Under 3) — day 28, dose 2, under 3
Symptoms: Slight cough x 2 days
Release 12 (Under 3) — 3 months, dose 2, under 3
Symptoms: Viral illness x 2, not 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 | Cough | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release