MBB-28186-06403
2 vaccinations
4 coded responses
18 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 754 / TX
- Registered
- 2021-08-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
JL2-15731-21363
Child or adolescent in my care · Male · 2021-10-08
Timeline
-
2021-08-30
Registered in v-safe
-
2021-08-30
Dose 1 — Moderna
- 2021-08-30
-
2021-08-31
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-09-01
- 2021-09-02
- 2021-09-03
- 2021-09-04
- 2021-09-05
- 2021-09-06
- 2021-09-13
-
2021-09-20
Survey response — day 21, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: Possibly some contractionsMedDRA releases: 2024-11 · check-in free text available
-
2021-09-27
Survey response — day 28, dose 1MedDRA: Dizziness, Muscle spasms, Pregnancy — Feeling: GoodFree text: Some cramping and dizziness possibly related to pregnancyMedDRA releases: 2024-11 · check-in free text available
-
2021-10-01
Dose 2 — ModernaCo-administered: Flu:Tetanus
- 2021-10-04
- 2021-10-05
-
2021-10-06
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Good · Fatigue or tirednessFree text: Light headedMedDRA releases: 2024-11 · check-in free text available
- 2021-10-08
-
2021-10-15
Survey response — day 14, dose 2MedDRA: Abdominal pain upper, Back pain, Dizziness, Nausea — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Nausea stomach and back ache dizzinessMedDRA releases: 2024-11 · check-in free text available
-
2021-10-15
Report sent to call center — day 14, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-10-20
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-10-24
- 2021-11-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-30 | Moderna | No |
| 2 | 2021-10-01 | Moderna | Flu:Tetanus |
Call center
1 call center case
1 successful
Free text
Release 9 — day 21, dose 1
Symptoms: Possibly some contractions
Release 9 — day 28, dose 1
Symptoms: Some cramping and dizziness possibly related to pregnancy
Release 10 — days 1–6 daily, dose 2
Systemic reaction (other): Light headed
Release 10 — day 14, dose 2
Symptoms: Nausea stomach and back ache dizziness
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 pain upper | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release