ATN-18261-91587
4 vaccinations
3 coded responses
44 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 686 / NE
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
5Y4-12919-78907
Child or adolescent in my care · Male · 2023-02-20
Timeline
-
2021-03-31
Registered in v-safe
-
2021-04-01
Dose 1 — Moderna
-
2021-04-01
Survey response — day 0, dose 1MedDRA: No adverse event — Feeling: Good · Joint painsFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
-
2021-04-22
Survey response — day 21, dose 1MedDRA: Breast feeding, Galactostasis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Clogged ducts. I'm currently breastfeeding. I had one on the 15th & another on the 19thMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-22
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-04-27
Dose 2 — Moderna
- 2021-04-27
-
2021-04-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness · HeadacheAdult check-in
- 2021-04-30
-
2021-05-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-05-02
- 2021-05-03
- 2021-05-04
- 2021-05-11
-
2021-05-18
Survey response — day 21, dose 2MedDRA: Cough, Nasopharyngitis, Rhinorrhoea — Feeling: GoodFree text: Cold like symptoms, runny nose, coughMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-25
- 2021-06-01
- 2021-06-08
- 2021-07-27
- 2021-10-26
-
2021-12-24
Dose 3 — Moderna
-
2021-12-26
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fever · Chills, Fatigue or tirednessAdult check-in
- 2021-12-27
- 2021-12-28
- 2021-12-29
- 2021-12-30
- 2021-12-31
- 2022-01-07
- 2022-01-14
- 2022-01-21
- 2022-01-28
- 2022-02-04
-
2022-02-26
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-25
- 2022-06-26
-
2022-11-25
Dose 4 — ModernaCo-administered: Flu
- 2022-12-18
- 2022-12-23
- 2022-12-30
- 2023-01-06
- 2023-02-27
- 2023-05-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna | |
| 2 | 2021-04-27 | Moderna | |
| 3 | 2021-12-24 | Moderna | No |
| 4 | 2022-11-25 | Moderna | Flu |
Call center
1 call center case
1 successful
Free text
Release 6 — day 0, dose 1
Systemic reaction (other): No
Release 7 — day 21, dose 1
Symptoms: Clogged ducts. I'm currently breastfeeding. I had one on the 15th & another on the 19th
Release 8 — day 21, dose 2
Symptoms: Cold like symptoms, runny nose, cough
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 | Breast feeding | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Galactostasis | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release