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UB5-31287-10977

3 vaccinations 1 coded response 32 check-ins 0 free-text entries 2 call cases
Sex
Male
Age at first dose
0-4
ZIP prefix
217 / MD
Registered
2022-10-23
Relationship
Child or adolescent in my care
Guardian
HFK-20530-01144
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2022-10-23
    Registered in v-safe
  2. 2022-10-23
    Dose 1 — Moderna
  3. 2022-10-23
    Health check-in — day 0, dose 1, under 3
    Feeling: Good · Rash, not including the immediate area around the injection site
    Under 3 check-in
  4. 2022-10-24
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · Sleepiness
    Under 3 check-in
  5. 2022-10-25
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  6. 2022-10-26
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  7. 2022-10-27
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  8. 2022-10-28
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  9. 2022-10-29
    Health check-in — days 1–6 daily, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  10. 2022-10-30
    Health check-in — day 7, dose 1, under 3
    Feeling: Good · None
    Under 3 check-in
  11. 2022-11-07
    Health check-in — day 14, dose 1, under 3
    Feeling: Good
    Under 3 check-in
  12. 2022-11-13
    Health check-in — day 21, dose 1, under 3
    Feeling: Good
    Under 3 check-in
  13. 2022-11-22
    Dose 2 — Moderna
  14. 2022-11-22
    Health check-in — day 0, dose 2, under 3
    Feeling: Good · None
    Under 3 check-in
  15. 2022-11-24
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Fair · None
    Under 3 check-in
  16. 2022-11-25
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Fair · None
    Under 3 check-in
  17. 2022-11-26
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Fair · None
    Under 3 check-in
  18. 2022-11-28
    Health check-in — days 1–6 daily, dose 2, under 3
    Feeling: Fair · None
    Under 3 check-in
  19. 2022-11-29
    Health check-in — day 7, dose 2, under 3
    Feeling: Good · None
    Under 3 check-in
  20. 2022-12-06
    Health check-in — day 14, dose 2, under 3
    Feeling: Good
    Under 3 check-in
  21. 2022-12-15
    Health check-in — day 21, dose 2, under 3
    Feeling: Fair
    Under 3 check-in
  22. 2022-12-20
    Health check-in — day 28, dose 2, under 3
    Feeling: Good
    Under 3 check-in
  23. 2022-12-27
    Health check-in — day 35, dose 2, under 3
    Feeling: Fair
    Under 3 check-in
  24. 2023-01-03
    Survey response — day 42, dose 2, under 3
    MedDRA: Bronchiolitis — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  25. 2023-01-03
    Report sent to call center — day 42, dose 2, under 3
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  26. 2023-01-04
  27. 2023-01-27
    Dose 3 — Moderna
  28. 2023-01-29
    Health check-in — days 1–6 daily, dose 3, under 3
    Feeling: Good · Sleepiness
    Under 3 check-in
  29. 2023-01-30
    Health check-in — days 1–6 daily, dose 3, under 3
    Feeling: Good · None
    Under 3 check-in
  30. 2023-01-31
    Health check-in — days 1–6 daily, dose 3, under 3
    Feeling: Good · None
    Under 3 check-in
  31. 2023-02-02
    Health check-in — days 1–6 daily, dose 3, under 3
    Feeling: Poor · Fever · Irritability/crying, Diarrhea · Be unable to work or attend school
    Under 3 check-in
  32. 2023-02-03
    Health check-in — day 7, dose 3, under 3
    Feeling: Poor · Fever · Sleepiness, Irritability/crying, Loss of appetite, Diarrhea · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Under 3 check-in
  33. 2023-02-03
    Report sent to call center — day 7, dose 3, under 3
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  34. 2023-02-06
  35. 2023-02-06
  36. 2023-02-10
    Health check-in — day 14, dose 3, under 3
    Feeling: Good
    Under 3 check-in
  37. 2023-02-17
    Health check-in — day 21, dose 3, under 3
    Feeling: Good
    Under 3 check-in
  38. 2023-02-24
    Health check-in — day 28, dose 3, under 3
    Feeling: Good
    Under 3 check-in
  39. 2023-03-03
    Health check-in — day 35, dose 3, under 3
    Feeling: Good
    Under 3 check-in
  40. 2023-03-10
    Health check-in — day 42, dose 3, under 3
    Feeling: Good
    Under 3 check-in
  41. 2023-04-28
    Health check-in — 3 months, dose 3, under 3
    Feeling: Good
    Under 3 check-in

Vaccinations

DoseDateManufacturerCo-administered
12022-10-23Moderna No
22022-11-22Moderna No
32023-01-27Moderna No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

None.

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

FieldPreferred term2021-092023-042024-11
SDBronchiolitis · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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