Y6L-11365-99455
2 vaccinations
2 coded responses
17 check-ins
1 free-text entry
1 call case
- Sex
- Male
- Age at first dose
- 0-4
- ZIP prefix
- 631 / MO
- Registered
- 2022-06-28
- Relationship
- Child or adolescent in my care
- Guardian
- CF2-29425-82131
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2022-06-28
Registered in v-safe
-
2022-06-28
Dose 1 — Moderna
- 2022-06-28
- 2022-06-30
- 2022-07-01
- 2022-07-02
- 2022-07-03
- 2022-07-04
- 2022-07-06
- 2022-07-12
- 2022-07-19
-
2022-07-30
Dose 2 — Moderna
- 2022-08-11
- 2022-08-13
- 2022-08-20
-
2022-08-29
Survey response — day 28, dose 2, dependentMedDRA: Conjunctivitis, Ear infection — Feeling: Good · 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: Pink eye and ear infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-08-29
Report sent to call center — day 28, 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)
-
2022-08-30
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-09-03
- 2022-09-10
- 2022-10-29
-
2023-01-28
Survey response — 6 months, dose 2, dependentMedDRA: COVID-19, Gastroenteritis viral, Nasopharyngitis, Pyrexia, Respiratory tract congestion — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2022-06-28 | Moderna | No |
| 2 | 2022-07-30 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 12 — day 28, dose 2, dependent
Symptoms: Pink eye and ear infection
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 | COVID-19 | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Gastroenteritis viral | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release