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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1019778



Case Details

VAERS ID: 1019778 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-02-01
Onset:2021-02-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Ultrasound scan
SMQs:, Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal vitamin
Current Illness: none
Preexisting Conditions: childhood asthma
Allergies: none
Diagnostic Lab Data: Ultrasound 2/8/21
CDC Split Type:

Write-up: Miscarriage 1 week post getting dose 1 of vaccine. Estimated due date was 08/18/2021. Previous pregnancy history is 3 pregnancies, with 3 full term live births, no complications.


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