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

This is VAERS ID 1054987



Case Details

VAERS ID: 1054987 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-01-20
Onset:2021-01-27
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Abortion spontaneous, Ultrasound scan, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vit
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ultrasound with low heart rate of fetus. Hcg levels decline from Wednesday 26-friday 29 from 5,400 to 1,500.
CDC Split Type:

Write-up: Pregnancy history: 1 previous pregnancy with healthy full term vaginal delivery. No complications. Estimated due date: Sept, 23, 2021. Symptoms: vaginal bleeding starting Jan 26th. Progressing to miscarriage on 1/29/21


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