XKZ-29817-72129
2 vaccinations
2 coded responses
18 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 209 / MD
- Registered
- 2022-06-27
- Relationship
- Child or adolescent in my care
- Guardian
- CCK-28769-16123
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-22
Dose 1 — Moderna
-
2022-06-27
Registered in v-safe
-
2022-06-27
Health check-in — days 1–6 daily, dose 1, dependentFeeling: Good · Site: Pain · NoneAdult check-in
- 2022-06-28
- 2022-06-29
- 2022-07-06
- 2022-07-13
-
2022-07-20
Dose 2 — Moderna
- 2022-07-20
- 2022-07-21
- 2022-07-22
- 2022-07-24
- 2022-07-25
- 2022-07-26
- 2022-07-27
- 2022-08-03
-
2022-08-10
Survey response — day 21, dose 2, dependentMedDRA: Ear pain, Lethargy, Rhinorrhoea — 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: Earache, runny nose, general lethargyMedDRA releases: 2024-11 · check-in free text available
-
2022-08-10
Report sent to call center — day 21, 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)
-
2022-08-11
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-08-17
Survey response — day 28, dose 2, dependentMedDRA: Conjunctivitis — Feeling: Good · Be unable to work or attend schoolFree text: ConjunctivitisMedDRA releases: 2024-11 · check-in free text available
- 2022-08-31
- 2022-10-19
- 2023-01-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-22 | Moderna | No |
| 2 | 2022-07-20 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 12 — day 21, dose 2, dependent
Symptoms: Earache, runny nose, general lethargy
Release 12 — day 28, dose 2, dependent
Symptoms: Conjunctivitis
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 | Ear pain | · | · | ✓ |
| SD | Lethargy | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release