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This is VAERS ID 1081203

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1081203
VAERS Form:2
Age:33.0
Sex:Female
Location:Tennessee
Vaccinated:2021-02-04
Onset:2021-03-04
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Public      Purchased by: ??
Symptoms: Abortion spontaneous, Ultrasound uterus abnormal

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: Azelastine nasal spray, benadryl, Prenatal vitamins, Breo Ellipts, Zyrtec, Pristiq
Current Illness: Asthma, Anxiety
Preexisting Conditions: Asthma, Anxiety
Allergies: Cats, Grass Pollen, Mold, Oak trees
Diagnostic Lab Data: Ultrasound confirmed spontaneous abortion
CDC 'Split Type':

Write-up: Patient had LMP on 1/12/21, so was most likely early pregnant at the time of her first vaccine. She then experienced a miscarriage on 3/1/21. She was assessed in the ER and then in our OBGYN office.


Changed on 5/14/2021

VAERS ID: 1081203 Before After
VAERS Form:2
Age:33.0
Sex:Female
Location:Tennessee
Vaccinated:2021-02-04
Onset:2021-03-04
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Public      Purchased by: ??
Symptoms: Abortion spontaneous, Ultrasound uterus abnormal

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: Azelastine nasal spray, benadryl, Prenatal vitamins, Breo Ellipts, Zyrtec, Pristiq
Current Illness: Asthma, Anxiety
Preexisting Conditions: Asthma, Anxiety
Allergies: Cats, Grass Pollen, Mold, Oak trees trees
Diagnostic Lab Data: Ultrasound confirmed spontaneous abortion
CDC 'Split Type':

Write-up: Patient had LMP on 1/12/21, so was most likely early pregnant at the time of her first vaccine. She then experienced a miscarriage on 3/1/21. She was assessed in the ER and then in our OBGYN office.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1081203&WAYBACKHISTORY=ON


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