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From the 11/12/2021 release of VAERS data:

This is VAERS ID 1433054

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Case Details

VAERS ID: 1433054 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Foetal death
SMQs:, 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Pregnancy
Allergies:
Diagnostic Lab Data:
CDC Split Type: BEPFIZER INC2021699309

Write-up: Intra-uterine death; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority BE-FAMHP-DHH-N2021-95109. This is a maternal report. A female patient of an unspecified age received bnt162b2 (COMIRNATY), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as DOSE NUMBER UNKNOWN, SINGLE for covid-19 immunisation. Medical history included pregnancy. The patient''s concomitant medications were not reported. The patient experienced unborn child died intra-uterine on an unspecified date. The mother reported she became pregnant while taking bnt162b2. The mother was 35 weeks pregnant at the onset of the event. The fetal outcome is intrauterine death. The outcome of the event was unknown.


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