XDT-10010-10124

3 vaccinations 1 coded response 2 check-ins 0 free-text entries 0 call cases

Sex: Male
Age at first dose: 0-4
ZIP prefix: 145 / NY
Registered: 2022-06-23

Relationship: Child or adolescent in my care
Guardian: J4M-12934-16626
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-11-12
Dose 1 — Moderna
2021-12-10
Dose 2 — Moderna
2022-06-23
Registered in v-safe
2022-10-14
Dose 3 — Moderna
2022-12-12
Health check-in — 12 months, dose 2, under 3
Feeling: Good

Under 3 check-in
2023-04-14
Survey response — 6 months, dose 3, under 3
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-11-12	Moderna	No
2	2021-12-10	Moderna	No
3	2022-10-14	Moderna	No

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
SD	Nasopharyngitis	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓

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