National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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

This is VAERS ID 1036567



Case Details

VAERS ID: 1036567 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-01-27
Onset:2021-01-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Exposure during pregnancy, Foetal death, Headache, Nausea, Pyrexia, Ultrasound foetal abnormal
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pre-natal vitamin and Bonjesta
Current Illness: Reports only morning sickness, related to pregnancy.
Preexisting Conditions: Denies
Allergies: NKDA, NKA
Diagnostic Lab Data: 2/1/21 Fetal US reported as showed fetal demise during week 8, which is the same week as she received the #2 COVID vaccine
CDC Split Type:

Write-up: reports that she was approximately 8 weeks pregnant at the time of her #2 COVID vaccine on 1/27/21. She reports she had a normal prenatal US at 7 weeks. She reports on 1/27/21, she had vaccine side effects of fever/chills, headache, and nausea. She notes on 1/29/21 most of her vaccine side effect symptoms resolved, but she is still suffering from headaches. She also notes that her morning sickness was gone on 1/29/21. She reports she called her OB, he brought her in for a repeat US on 2/1/21. Notes that she has two healthy children and suffered a miscarriage in May 2020.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1036567


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166