VVA-36795-91095
3 vaccinations
4 coded responses
31 check-ins
2 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 940 / CA
- Registered
- 2022-06-24
- Relationship
- Child or adolescent in my care
- Guardian
- XG5-28617-20454
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-21
Dose 1 — Moderna
-
2022-06-24
Registered in v-safe
- 2022-06-25
-
2022-06-26
Survey response — days 1–6 daily, dose 1, dependentMedDRA: Fatigue, Lacrimation increased, Mood altered — Feeling: Good · Fatigue or tirednessFree text: Has been overtired, teary, and moody since getting the shot.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-27
- 2022-06-28
-
2022-07-19
Dose 2 — Moderna
- 2022-07-19
-
2022-07-20
Health check-in — days 1–6 daily, dose 2, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-07-22
- 2022-07-23
- 2022-07-24
- 2022-07-25
- 2022-07-26
- 2022-08-02
- 2022-08-09
- 2022-08-16
- 2022-08-23
- 2022-08-30
- 2022-10-18
-
2022-12-15
Dose 3 — Moderna
-
2022-12-16
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain · NoneAdult check-in
-
2022-12-17
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-12-18
- 2022-12-19
- 2022-12-20
- 2022-12-21
- 2022-12-22
-
2022-12-29
Survey response — day 14, dose 3, dependentMedDRA: Vomiting — Feeling: Good · Be unable to do your normal daily activitiesFree text: Threw up.MedDRA releases: 2024-11 · check-in free text available
- 2023-01-05
- 2023-01-12
- 2023-01-19
-
2023-01-26
Survey response — day 42, dose 3, dependentMedDRA: Gastroenteritis viral, Malaise, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
-
2023-03-16
Survey response — 3 months, dose 3, dependentMedDRA: Nasopharyngitis — Feeling: GoodMedDRA releases: 2024-11
- 2023-06-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-21 | Moderna | No |
| 2 | 2022-07-19 | Moderna | No |
| 3 | 2022-12-15 | Moderna | No |
Free text
Release 12 — days 1–6 daily, dose 1, dependent
Systemic reaction (other): Has been overtired, teary, and moody since getting the shot.
Release 12 — day 14, dose 3, dependent
Symptoms: Threw up.
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 | Gastroenteritis viral | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Lacrimation increased | · | · | ✓ |
| SRO | Mood altered | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release