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

This is VAERS ID 1349559



Case Details

VAERS ID: 1349559 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-16
Onset:2021-05-06
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous
SMQs:, Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: WELLBUTRIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021523737

Write-up: I had a miscarriage and they estimated the baby died at 16 weeks 5 days.; This is a spontaneous report from a contactable consumer (patient). A 36-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in arm left on 16Apr2021 14:00 (Batch/Lot Number: EW0161) as single dose for COVID-19 immunization. Medical history included allergies penicillin and COVID-19. The patient''s concomitant medications included bupropion hydrochloride (WELLBUTRIN) within 2 weeks of vaccination. Last menstrual period (LMP) was reported as 30Dec2020. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. No other medications the patient received within 2 weeks of vaccination. Prior to vaccination, patient was diagnosed with COVID-19. Since the vaccination, patient has not been tested for COVID-19. On 06May2021 16:00, the patient had a miscarriage and they estimated the baby died at 16 weeks 5 days. There were no genetic disorders detected, so the cause was unknown. Patient thought maybe the vaccine could have something to do with it. The adverse event result in Doctor or other healthcare professional office/clinic visit. Treatment received for the adverse event included fetal demise removal. Outcome of the event was recovering. Information on Lot/Batch number was available. Additional information has been requested.


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