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This is VAERS ID 1040307

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2021

VAERS ID: 1040307
VAERS Form:2
Age:31.0
Sex:Female
Location:Washington
Vaccinated:2021-02-05
Onset:2021-02-07
Submitted:0000-00-00
Entered:2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Abortion spontaneous

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Endometrin, progesterone in oil IM shots, Estrogen pills
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Early miscarriage occurred on Sunday, 2/7/2021. No previous pregnancies

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1040307&WAYBACKHISTORY=ON


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