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

This is VAERS ID 1106398



Case Details

VAERS ID: 1106398 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-09
Onset:2021-02-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Abortion missed, Chlamydia test negative, Exposure during pregnancy, Full blood count, Glycosylated haemoglobin, Treponema test negative, Urine analysis, Uterine dilation and curettage
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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: CBC unremarkable on 2/4/2021 and 2/18/2021. UA unremarkable 2/4/2021. Chlamydia/GC PCR negative, quantiferon TB negative, syphilis negative 2/4/2021. Varicella and Rubella titers positive for immunity 2/4/2021. HgbA1c 5.0 2/4/2021.
CDC Split Type:

Write-up: Initial prenatal visit on 2/4/2021, pregnancy measuring 6 weeks with visible cardiac activity. Vaccine received 2/9/2021. Repeat ultrasound 2/18/2021, no cardiac activity seen, pregnancy still measuring 6 weeks. D&C procedure on 2/23/2021 for missed abortion.


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