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

This is VAERS ID 1060779



Case Details

VAERS ID: 1060779 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-12
Onset:2021-02-07
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Foetal death, Human chorionic gonadotropin positive, Ultrasound antenatal screen abnormal
SMQs:, Tumour markers (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), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pre-natal vitamins Vyvanse 50mg Citalopram 40mg
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data: Feb. 10, 2021: Ultrasound (showing embryo of approx. 7 weeks with no heartbeat) Feb. 10, 2021: beta hCG levels. (approx. 17,000+) Feb. 12, 2021: Repeat of beta hCG levels. (approx. 7,000+, consistent with miscarriage) Feb. 19, 2021: Ultrasound (confirming loss of gestational sac and contents)
CDC Split Type:

Write-up: At 5 weeks, 5 days pregnant I received the 1st Covid-19 dose. I started bleeding the evening of Feb. 7, 2021. The bleeding continued to increase. I visited the Emergency Department on Feb. 10, 2021 and learned my baby had died around 7 weeks into the pregnancy.


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