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This is VAERS ID 1063650

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1063650
VAERS Form:2
Age:34.0
Sex:Female
Location:California
Vaccinated:2021-01-06
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / -

Administered by: Public      Purchased by: ??
Symptoms: Pain in extremity, Ultrasound abdomen, Foetal death, Exposure during pregnancy

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: No
Current Illness: No
Preexisting Conditions: No
Allergies: I am allergic to penicillin, clindamycin and tree nuts.
Diagnostic Lab Data: I had an US ABD and Transvaginal.
CDC 'Split Type': vsafe

Write-up: I had a soreness in my arm. The two weeks later on the 21st of January, I had a routine OB appointment and we did an US only to find out that the fetus was no longer alive. I had to have a DNC the following week. Participant is not sure if it is vaccine related but wanted to file a report anyway.


Changed on 5/7/2021

VAERS ID: 1063650 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:California
Vaccinated:2021-01-06
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / -

Administered by: Public      Purchased by: ??
Symptoms: Pain in extremity, Ultrasound abdomen, Foetal death, Exposure during pregnancy

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: No
Current Illness: No
Preexisting Conditions: No
Allergies: I am allergic to penicillin, clindamycin and tree nuts. nuts.
Diagnostic Lab Data: I had an US ABD and Transvaginal.
CDC 'Split Type': vsafe

Write-up: I had a soreness in my arm. The two weeks later on the 21st of January, I had a routine OB appointment and we did an US only to find out that the fetus was no longer alive. I had to have a DNC the following week. Participant is not sure if it is vaccine related but wanted to file a report anyway.


Changed on 5/14/2021

VAERS ID: 1063650 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:California
Vaccinated:2021-01-06
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / -

Administered by: Public      Purchased by: ??
Symptoms: Pain in extremity, Ultrasound abdomen, Foetal death, Exposure during pregnancy

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: No
Current Illness: No
Preexisting Conditions: No
Allergies: I am allergic to penicillin, clindamycin and tree nuts. nuts.
Diagnostic Lab Data: I had an US ABD and Transvaginal.
CDC 'Split Type': vsafe

Write-up: I had a soreness in my arm. The two weeks later on the 21st of January, I had a routine OB appointment and we did an US only to find out that the fetus was no longer alive. I had to have a DNC the following week. Participant is not sure if it is vaccine related but wanted to file a report anyway.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1063650&WAYBACKHISTORY=ON


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