XN5-84101-14506
2 vaccinations
2 coded responses
8 check-ins
1 free-text entry
1 call case
- Sex
- Female
- Age at first dose
- 0-4
- ZIP prefix
- 550 / MN
- Registered
- 2022-12-21
- Relationship
- Child or adolescent in my care
- Guardian
- K52-14982-02515
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-11-02
Dose 1 — ModernaCo-administered: Flu:Hepatitis B:Hib:Pneumonia:Polio:Rotavirus:Tetanus
-
2022-12-10
Dose 2 — ModernaCo-administered: Flu
-
2022-12-21
Registered in v-safe
- 2022-12-21
- 2022-12-24
-
2022-12-31
Survey response — day 21, dose 2, under 3MedDRA: Upper respiratory tract infection — 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: Upper respiratory infection, not COVID or related to vaccineMedDRA releases: 2024-11 · check-in free text available
-
2022-12-31
Report sent to call center — day 21, dose 2, under 3Be 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)
-
2023-01-03
Call successfulCompleted over the phone
- 2023-01-07
- 2023-01-14
-
2023-01-21
Survey response — day 42, dose 2, under 3MedDRA: Abdominal discomfort, COVID-19, Cough, Diarrhoea, Fatigue, Irritability — Feeling: GoodMedDRA releases: 2024-11
- 2023-03-11
- 2023-06-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-11-02 | Moderna | Flu:Hepatitis B:Hib:Pneumonia:Polio:Rotavirus:Tetanus |
| 2 | 2022-12-10 | Moderna | Flu |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 12 (Under 3) — day 21, dose 2, under 3
Symptoms: Upper respiratory infection, not COVID or related to vaccine
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 discomfort | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Irritability | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release