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

This is VAERS ID 1066049



Case Details

VAERS ID: 1066049 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-01-06
Onset:2021-02-21
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abortion spontaneous, Ultrasound antenatal screen
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal vitamins
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: Ultra sound confirmed but dates not reported. No medical intervention reportedly needed to complete miscarriage.
CDC Split Type:

Write-up: Reported by patient to have been 9.5weeks pregnant when miscarriage happened.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1066049


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