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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1006634



Case Details

VAERS ID: 1006634 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-06
Onset:2021-01-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous incomplete, Exposure during pregnancy, Gene mutation identification test, Haemorrhage in pregnancy, Ultrasound antenatal screen abnormal, Uterine dilation and curettage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal vitamin
Current Illness: none
Preexisting Conditions: asthma, migraine
Allergies: Ceclor, doxycycline, PCN, sulfa
Diagnostic Lab Data: 1/19/21 - ultrasound confirming embryonic demise 1/20/21 - D&C for incomplete abortion
CDC Split Type:

Write-up: Spontaneous abortion. Pt was 9w1d at time of first Moderna COVID vaccine (EDD 8/9/2021). Two weeks later she began bleeding and was found to have an incomplete abortion with embryo measuring 9w1d. Proceeded to bleed heavily and D&C performed. Uncomplicated recovery. Genetic studies in process. Unknown if SAB is related to vaccine, though it appears embryonic demise occurred within a few days of vaccine administration.


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