XFC-29792-37623
3 vaccinations
2 coded responses
34 check-ins
1 free-text entry
2 call cases
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 430 / OH
- Registered
- 2022-09-16
- Relationship
- Child or adolescent in my care
- Guardian
- U5H-21137-90985
- Race
- Multiracial
- Ethnicity
- Hispanic or Latino
Timeline
-
2022-09-15
Dose 1 — Moderna
-
2022-09-16
Registered in v-safe
- 2022-09-16
- 2022-09-17
- 2022-09-18
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-22
- 2022-09-29
- 2022-10-06
-
2022-10-13
Dose 2 — Moderna
- 2022-10-16
- 2022-10-17
- 2022-10-18
- 2022-10-19
- 2022-10-20
- 2022-10-27
-
2022-11-03
Survey response — day 21, dose 2, under 3MedDRA: Croup infectious, Ear infection, Influenza virus test negative, SARS-CoV-2 test negative — Feeling: Good · 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: Diagnosed with croup and double ear infection. Rapid respiratory panel indicated COVID negative, flu negative, RSV negative. She's returned to health on abx.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-03
Report sent to call center — day 21, dose 2, under 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-04
-
2022-11-04
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-11-10
- 2022-11-17
- 2022-11-24
- 2023-01-12
-
2023-02-03
Dose 3 — Moderna
-
2023-02-03
Health check-in — day 0, dose 3, under 3Feeling: Good · Site: Pain · Sleepiness, Irritability/cryingUnder 3 check-in
-
2023-02-04
Health check-in — days 1–6 daily, dose 3, under 3Feeling: Good · Site: Pain, Redness, Swelling/hardness · NoneUnder 3 check-in
-
2023-02-05
Health check-in — days 1–6 daily, dose 3, under 3Feeling: Good · Site: Swelling/hardness · SleepinessUnder 3 check-in
- 2023-02-06
-
2023-02-07
Health check-in — days 1–6 daily, dose 3, under 3Feeling: Good · Site: Swelling/hardness · Sleepiness, Irritability/cryingUnder 3 check-in
-
2023-02-08
Health check-in — days 1–6 daily, dose 3, under 3Feeling: Good · Site: Swelling/hardness · NoneUnder 3 check-in
- 2023-02-09
- 2023-02-10
- 2023-02-17
- 2023-02-24
- 2023-03-03
- 2023-03-10
- 2023-03-17
-
2023-05-05
Survey response — 3 months, dose 3, under 3MedDRA: Conjunctivitis, Croup infectious, Erythema multiforme — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-05-05
Report sent to call center — 3 months, dose 3, under 3Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-05-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-09-15 | Moderna | No |
| 2 | 2022-10-13 | Moderna | No |
| 3 | 2023-02-03 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-03 | Successful 2022-11-04 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2023-05-05 | Unsuccessful |
Free text
Release 12 (Under 3) — day 21, dose 2, under 3
Symptoms: Diagnosed with croup and double ear infection. Rapid respiratory panel indicated COVID negative, flu negative, RSV negative. She's returned to health on abx.
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 | Conjunctivitis | · | · | ✓ |
| SD | Croup infectious | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Erythema multiforme | · | · | ✓ |
| SD | Influenza virus test negative | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release