VX6-19114-89800
3 vaccinations
3 coded responses
36 check-ins
3 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 612 / IL
- Registered
- 2022-06-22
- Relationship
- Child or adolescent in my care
- Guardian
- UU2-84105-27540
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2022-06-22
Registered in v-safe
-
2022-08-24
Dose 1 — Moderna
- 2022-08-25
- 2022-08-27
- 2022-08-29
- 2022-08-30
- 2022-08-31
-
2022-09-09
Survey response — day 14, dose 1, under 3MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend schoolFree text: Covid Positive 9/8/22MedDRA releases: 2024-11 · check-in free text available
-
2022-09-16
Survey response — day 21, dose 1, under 3MedDRA: Cough, Paranasal sinus hypersecretion — Feeling: FairFree text: Sinus drainage/coughMedDRA releases: 2024-11 · check-in free text available
-
2022-09-21
Survey response — day 28, dose 1, under 3MedDRA: Nasal congestion, Respiratory tract congestion — Feeling: FairFree text: Nasal and chest congestionMedDRA releases: 2024-11 · check-in free text available
- 2022-09-28
- 2022-10-06
-
2022-10-12
Dose 2 — Moderna
- 2022-10-12
- 2022-10-13
- 2022-10-14
- 2022-10-15
- 2022-10-16
- 2022-10-17
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-11-09
- 2022-11-16
- 2022-11-23
-
2022-12-21
Dose 3 — Moderna
- 2022-12-21
- 2022-12-22
- 2022-12-23
- 2022-12-24
- 2022-12-25
- 2022-12-26
- 2022-12-27
-
2022-12-29
Health check-in — day 7, dose 3, under 3Feeling: Good · Fever · None · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitUnder 3 check-in
-
2022-12-29
Report sent to call center — day 7, dose 3, under 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-12-30
Call successfulDoes not wish to fill out VAERS report
- 2023-01-04
- 2023-01-13
- 2023-01-18
- 2023-01-25
- 2023-03-24
- 2023-06-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-08-24 | Moderna | No |
| 2 | 2022-10-12 | Moderna | No |
| 3 | 2022-12-21 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-29 | Successful 2022-12-30 |
Does not wish to fill out VAERS report |
Free text
Release 12 (Under 3) — day 14, dose 1, under 3
Symptoms: Covid Positive 9/8/22
Release 12 (Under 3) — day 21, dose 1, under 3
Symptoms: Sinus drainage/cough
Release 12 (Under 3) — day 28, dose 1, under 3
Symptoms: Nasal and chest congestion
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 | COVID-19 | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release