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

This is VAERS ID 1096757



Case Details

VAERS ID: 1096757 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-02-02
Onset:2021-02-10
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure during pregnancy, Foetal death
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: prenatal vitamin
Current Illness: none
Preexisting Conditions: morbid obesity with body mass index of 46
Allergies: Cefaclor
Diagnostic Lab Data: See description above. At this writing, the cause of fetal death is unknown. In this situation, we often never know the cause of death.
CDC Split Type:

Write-up: Patient received her Covid 19 vaccines on 1/6/21 and 2/3/21. On 3/3/21 at her routine prenatal visit, she was diagnosed with an intrauterine fetal demise. Based on the fetal measurements, the demise happened at 17-18 weeks of gestation, which would be sometime between 2/6/21 and 2/13/21. Medically, I don''t suspect that the demise is related to the vaccine, but for the sake of accurate tracking, I feel compelled to report the sequence of events.


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