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

This is VAERS ID 1063601

Case Details

VAERS ID: 1063601 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arizona  
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Haemorrhage, Muscle spasms, Pregnancy, Pregnancy test positive
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: US of pregnancy (Feb 14th), then confirming pregnancy loss (Feb 18th)
CDC Split Type:

Write-up: COVID vaccine given Dec 24th, 2020 and second dose on Jan 16th, 2021. Conception occurred approx Jan 11th, 2021 pregnancy diagnosed Jan 26th, 2021. ED Oct 4th, 2021. US confirmation of pregnancy with gestational sac on Feb 14th, 2021. Miscarriage/SAB/pregnancy loss occurred spontaneously on Feb 18th, 2021 with bleeding, cramping. Pregnancy loss confirmed by ultrasound with OBGYN.

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