XHS-29904-40990
3 vaccinations
1 coded response
13 check-ins
0 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 605 / IL
- Registered
- 2022-12-14
- Relationship
- Child or adolescent in my care
- Guardian
- U8B-14889-89266
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-26
Dose 1 — Moderna
-
2022-07-25
Dose 2 — Moderna
-
2022-12-14
Registered in v-safe
-
2022-12-14
Dose 3 — Moderna
- 2022-12-14
- 2022-12-15
- 2022-12-16
- 2022-12-19
- 2022-12-20
- 2022-12-22
- 2022-12-30
- 2023-01-04
- 2023-01-11
- 2023-01-18
- 2023-01-25
-
2023-03-15
Survey response — 3 months, dose 3, dependentMedDRA: Abdominal pain upper — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-03-15
Report sent to call center — 3 months, dose 3, dependentGet care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-03-16
-
2023-03-21
Call successfulDoes not wish to fill out VAERS report
- 2023-06-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-26 | Moderna | No |
| 2 | 2022-07-25 | Moderna | No |
| 3 | 2022-12-14 | Moderna | No |
Call center
1 call center case
1 successful
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 | Abdominal pain upper | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release