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

This is VAERS ID 1038096



Case Details

VAERS ID: 1038096 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-01-26
Onset:2021-02-09
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), 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 malarone daily for malaria prophylaxies
Current Illness: none
Preexisting Conditions: history of PCOS
Allergies: none
Diagnostic Lab Data: No testing performed.
CDC Split Type:

Write-up: Pt is G1P0. At the time she received the vaccine on 1/26/21 she was 13 weeks pregnant. She had normal 1st trimester ultrasound and normal prenatal labs. Her EDD is August 5, 2021. On 2/9/21 she had a spontaneous miscarriage. No subsequent complications. No history of drug or alcohol abuse. No s/sx of other causes of a early 2nd trimester miscarriage. Of note the 1st trimester genetic testing was unable to be performed due to low fetal free cell DNA when she was at 10w. We were in the process of repeating the labs when the miscarriage happened. No history of COVID infection, no s/sx of COVID infection at the time of the miscarriage or subsequently. She was not tested.


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