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Concomitant Vaccination

1 forms  
Administrative Documentation
Description

Administrative Documentation

Alias
UMLS CUI-1
C1320722
Subject number
Description

Subject number

Data type

integer

Alias
UMLS CUI [1]
C2348585
Concomitant Vaccination
Description

Concomitant Vaccination

Alias
UMLS CUI-1
C0042196
UMLS CUI-2
C2347852
Has any vaccine other than the study vaccine(s) been administered during the timeframe as specified in the protocol?
Description

If yes, please record concomitant vaccination with trade name and/or generic name, route and vaccine administration date in the following item group.

Data type

text

Alias
UMLS CUI [1,1]
C0042196
UMLS CUI [1,2]
C2347852
UMLS CUI [1,3]
C0347984
UMLS CUI [1,4]
C1948053
UMLS CUI [1,5]
C2348563
UMLS CUI [2,1]
C1705847
UMLS CUI [2,2]
C0042196
UMLS CUI [2,3]
C3854006
Concomitant Vaccination
Description

Concomitant Vaccination

Alias
UMLS CUI-1
C0042196
UMLS CUI-2
C2347852
Please record the trade name and/or generic name of the concomitant vaccination.
Description

Trade name | generic name concomitant vaccination

Data type

text

Alias
UMLS CUI [1,1]
C2360065
UMLS CUI [1,2]
C0042196
UMLS CUI [1,3]
C2347852
UMLS CUI [2,1]
C0592502
UMLS CUI [2,2]
C0042196
UMLS CUI [2,3]
C2347852
Please record the route of administration of the concomitant vaccination.
Description

Drug administration route concomitant vaccination

Data type

text

Alias
UMLS CUI [1,1]
C0013153
UMLS CUI [1,2]
C0042196
UMLS CUI [1,3]
C2347852
Please record the vaccine administration date of the concomitant vaccination.
Description

Date of administration concomitant vaccination

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0042196
UMLS CUI [1,3]
C2347852
For GSK
Description

Clinical study sponsor comment

Data type

text

Alias
UMLS CUI [1,1]
C2347796
UMLS CUI [1,2]
C0947611
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Similar models

Concomitant Vaccination

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Documentation
C1320722 (UMLS CUI-1)
Subject number
Item
Subject number
integer
C2348585 (UMLS CUI [1])
Item Group
Concomitant Vaccination
C0042196 (UMLS CUI-1)
C2347852 (UMLS CUI-2)
Concomitant vaccination during during study protocol period | except for study vaccination
Item
Has any vaccine other than the study vaccine(s) been administered during the timeframe as specified in the protocol?
text
C0042196 (UMLS CUI [1,1])
C2347852 (UMLS CUI [1,2])
C0347984 (UMLS CUI [1,3])
C1948053 (UMLS CUI [1,4])
C2348563 (UMLS CUI [1,5])
C1705847 (UMLS CUI [2,1])
C0042196 (UMLS CUI [2,2])
C3854006 (UMLS CUI [2,3])
Item Group
Concomitant Vaccination
C0042196 (UMLS CUI-1)
C2347852 (UMLS CUI-2)
Trade name | generic name concomitant vaccination
Item
Please record the trade name and/or generic name of the concomitant vaccination.
text
C2360065 (UMLS CUI [1,1])
C0042196 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,3])
C0592502 (UMLS CUI [2,1])
C0042196 (UMLS CUI [2,2])
C2347852 (UMLS CUI [2,3])
Item
Please record the route of administration of the concomitant vaccination.
text
C0013153 (UMLS CUI [1,1])
C0042196 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,3])
Route of administration concomitant vaccination
Code List
Please record the route of administration of the concomitant vaccination.
CL Item
Intradermal (ID)
CL Item
Inhalation (IH)
CL Item
Intramuscular (IM)
CL Item
Intravenous (IV)
CL Item
Intranasal (NA)
CL Item
Other (OTH)
CL Item
Parenteral (PE)
CL Item
Oral (PO)
CL Item
Subcutaneous (SC)
CL Item
Sublingual (SL)
CL Item
Transdermal (TD)
CL Item
Unknown (UNK)
Date of administration concomitant vaccination
Item
Please record the vaccine administration date of the concomitant vaccination.
date
C0011008 (UMLS CUI [1,1])
C0042196 (UMLS CUI [1,2])
C2347852 (UMLS CUI [1,3])
Clinical study sponsor comment
Item
For GSK
text
C2347796 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
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