X8R-26974-03598
3 vaccinations
7 coded responses
26 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 605 / IL
- Registered
- 2022-07-13
- Relationship
- Child or adolescent in my care
- Guardian
- YZN-21709-44515
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-25
Dose 1 — Moderna
-
2022-07-13
Registered in v-safe
- 2022-07-13
- 2022-07-16
-
2022-07-23
Dose 2 — Moderna
- 2022-07-23
- 2022-07-24
- 2022-07-26
- 2022-07-28
- 2022-07-29
- 2022-08-01
- 2022-08-06
-
2022-08-13
Survey response — day 21, dose 2, dependentMedDRA: Dermatitis contact — Feeling: GoodFree text: New Contact dermatitis reaction on both arms to soapMedDRA releases: 2024-11 · check-in free text available
-
2022-08-20
Survey response — day 28, dose 2, dependentMedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: CovidMedDRA releases: 2024-11 · check-in free text available
- 2022-08-27
-
2022-09-05
Survey response — day 42, dose 2, dependentMedDRA: Cough, Nasopharyngitis, Pre-existing disease, Respiratory tract congestion, Rhinorrhoea — Feeling: FairFree text: Runny nose, cough, congestion either a cold or allergies (most likely)MedDRA releases: 2024-11 · check-in free text available
-
2022-10-24
Survey response — 3 months, dose 2, dependentMedDRA: Respiratory tract infection viral — Feeling: Poor · 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 visitFree text: Another respiratory virus but not CovidMedDRA releases: 2024-11 · check-in free text available
-
2022-10-24
Report sent to call center — 3 months, dose 2, dependentBe 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 · 1 call case(s)
- 2022-10-26
-
2023-01-21
Survey response — 6 months, dose 2, dependentMedDRA: Gastroenteritis, Rhinitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
-
2023-02-03
Dose 3 — Moderna
-
2023-02-04
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2023-02-05
- 2023-02-06
- 2023-02-08
- 2023-02-12
- 2023-02-17
- 2023-02-24
- 2023-03-03
-
2023-03-14
Survey response — day 35, dose 3, dependentMedDRA: Cough, Pyrexia, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
-
2023-03-17
Survey response — day 42, dose 3, dependentMedDRA: Cough, Pyrexia, Rhinorrhoea, 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
- 2023-05-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-25 | Moderna | No |
| 2 | 2022-07-23 | Moderna | No |
| 3 | 2023-02-03 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-24 | Unsuccessful |
Free text
Release 12 — day 21, dose 2, dependent
Symptoms: New Contact dermatitis reaction on both arms to soap
Release 12 — day 28, dose 2, dependent
Symptoms: Covid
Release 12 — day 42, dose 2, dependent
Symptoms: Runny nose, cough, congestion either a cold or allergies (most likely)
Release 12 — 3 months, dose 2, dependent
Symptoms: Another respiratory virus but 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 | COVID-19 | · | · | ✓ |
| SD | Dermatitis contact | · | · | ✓ |
| SD | Gastroenteritis | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Respiratory tract infection viral | · | · | ✓ |
| SD | Rhinitis | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release