UH9-15193-59180
1 vaccination
2 coded responses
10 check-ins
0 free-text entries
0 call cases
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 787 / TX
- Registered
- 2023-05-15
- Relationship
- Child or adolescent in my care
- Guardian
- KB8-19934-25342
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2023-05-15
Registered in v-safe
-
2023-05-15
Dose 1 — ModernaCo-administered: Hepatitis B:Hib:Other:Polio:Rotavirus:Tetanus
-
2023-05-15
Health check-in — day 0, dose 1, under 3Feeling: Fair · Site: Pain · Irritability/crying, DiarrheaUnder 3 check-in
-
2023-05-16
Survey response — days 1–6 daily, dose 1, under 3MedDRA: Crying, Discomfort, Feeling hot, Hypersomnia, Insomnia — Feeling: Poor · Site: Pain, Redness, Swelling/hardness · Fever · Sleepiness, Irritability/crying · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
-
2023-05-17
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Good · Site: Swelling/hardness · Sleepiness, VomitingUnder 3 check-in
- 2023-05-19
-
2023-05-20
Survey response — days 1–6 daily, dose 1, under 3MedDRA: Insomnia — Feeling: Fair · Fever · Irritability/cryingMedDRA releases: 2024-11
-
2023-05-21
Health check-in — days 1–6 daily, dose 1, under 3Feeling: Fair · Irritability/crying · Be unable to do your normal daily activitiesUnder 3 check-in
- 2023-05-22
- 2023-05-29
- 2023-06-05
- 2023-06-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2023-05-15 | Moderna | Hepatitis B:Hib:Other:Polio:Rotavirus:Tetanus |
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SRO | Crying | · | · | ✓ |
| SRO | Discomfort | · | · | ✓ |
| SRO | Feeling hot | · | · | ✓ |
| SRO | Hypersomnia | · | · | ✓ |
| SRO | Insomnia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release