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

This is VAERS ID 1027542



Case Details

VAERS ID: 1027542 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-01-03
Onset:2021-02-11
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-02-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abortion spontaneous, Blood test, Pregnancy, Ultrasound antenatal screen
SMQs:, Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (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: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Miscarriage confirmed via blood test and ultrasound.
CDC Split Type:

Write-up: I conceived a pregnancy within 2 weeks of my vaccine which ultimately resulted in a miscarriage less than 6 weeks after the injection.


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