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This is VAERS ID 1106398

History of Changes from the VAERS Wayback Machine

First Appeared on 4/8/2021

VAERS ID: 1106398
VAERS Form:2
Age:26.0
Sex:Female
Location:California
Vaccinated:2021-02-09
Onset:2021-02-18
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, Full blood count, Glycosylated haemoglobin, Urine analysis, Uterine dilation and curettage, Chlamydia test negative, Treponema test negative, Exposure during pregnancy

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? Yes, days: 1     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.


Changed on 5/7/2021

VAERS ID: 1106398 Before After
VAERS Form:2
Age:26.0
Sex:Female
Location:California
Vaccinated:2021-02-09
Onset:2021-02-18
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, Full blood count, Glycosylated haemoglobin, Urine analysis, Uterine dilation and curettage, Chlamydia test negative, Treponema test negative, Exposure during pregnancy

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: No
Preexisting Conditions: No
Allergies: No 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.


Changed on 5/14/2021

VAERS ID: 1106398 Before After
VAERS Form:2
Age:26.0
Sex:Female
Location:California
Vaccinated:2021-02-09
Onset:2021-02-18
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, Full blood count, Glycosylated haemoglobin, Urine analysis, Uterine dilation and curettage, Chlamydia test negative, Treponema test negative, Exposure during pregnancy

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: No
Preexisting Conditions: No
Allergies: No 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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