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This is VAERS ID 1103353

History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1103353
VAERS Form:2
Age:35.0
Sex:Female
Location:Illinois
Vaccinated:2021-02-15
Onset:2021-03-01
Submitted:0000-00-00
Entered:2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 2 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Abortion spontaneous, Ultrasound uterus, Uterine dilation and curettage, Blood test, Transfusion, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pre-Natal Vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Augmentin, Vancomycin
Diagnostic Lab Data: Ultra Sound, Blood work on 3/1/21 (No fetal heart tones) Ultra Sound confirming no heart beat 3/8/21 Blood Transfusions on 3/5/21 Dilation and Curettage on 3/8/21
CDC 'Split Type':

Write-up: Miscarriage 2 weeks after receiving the first dose (March 1, 2021). Baby had a heart beat, then slowly died. Ultra Sound Showing Fetal Bradycardia on 2/26/21.


Changed on 5/14/2021

VAERS ID: 1103353 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:Illinois
Vaccinated:2021-02-15
Onset:2021-03-01
Submitted:0000-00-00
Entered:2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 2 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Abortion spontaneous, Ultrasound uterus, Uterine dilation and curettage, Blood test, Transfusion, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pre-Natal Vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Augmentin, Vancomycin Vancomycin
Diagnostic Lab Data: Ultra Sound, Blood work on 3/1/21 (No fetal heart tones) Ultra Sound confirming no heart beat 3/8/21 Blood Transfusions on 3/5/21 Dilation and Curettage on 3/8/21
CDC 'Split Type':

Write-up: Miscarriage 2 weeks after receiving the first dose (March 1, 2021). Baby had a heart beat, then slowly died. Ultra Sound Showing Fetal Bradycardia on 2/26/21.

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