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This is VAERS ID 1016753

History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1016753
VAERS Form:2
Age:42.0
Sex:Female
Location:Connecticut
Vaccinated:2021-01-28
Onset:2021-02-04
Submitted:0000-00-00
Entered:2021-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abortion spontaneous, Pregnancy, Pregnancy test urine positive, Haemorrhage, Human chorionic gonadotropin

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenate DHA
Current Illness: None
Preexisting Conditions: None
Allergies: none
Diagnostic Lab Data: serum quantitative beta-hCG drawn on 2/4/21 (results not available).
CDC 'Split Type':

Write-up: 42yo G2P0010 at 3+6 weeks GA by LMP 1/1/2021 with EDD 10/8/2021 on day of Vaccine Dose #2 (1/28/2021), positive urine pregnancy test on 1/30/21. Bleeding began on 2/4/2021, and complete miscarriage occurred on 2/5-2/6.


Changed on 5/14/2021

VAERS ID: 1016753 Before After
VAERS Form:2
Age:42.0
Sex:Female
Location:Connecticut
Vaccinated:2021-01-28
Onset:2021-02-04
Submitted:0000-00-00
Entered:2021-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abortion spontaneous, Pregnancy, Pregnancy test urine positive, Haemorrhage, Human chorionic gonadotropin

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenate DHA
Current Illness: None
Preexisting Conditions: None
Allergies: none none
Diagnostic Lab Data: serum quantitative beta-hCG drawn on 2/4/21 (results not available).
CDC 'Split Type':

Write-up: 42yo G2P0010 at 3+6 weeks GA by LMP 1/1/2021 with EDD 10/8/2021 on day of Vaccine Dose #2 (1/28/2021), positive urine pregnancy test on 1/30/21. Bleeding began on 2/4/2021, and complete miscarriage occurred on 2/5-2/6.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1016753&WAYBACKHISTORY=ON


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