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

This is VAERS ID 1740111

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Case Details

VAERS ID: 1740111 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abortion spontaneous, Illness, Maternal exposure during pregnancy
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: miscarriage when she became sick from the first vaccine; became sick from the first vaccine; Maternal exposure during pregnancy; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of ABORTION SPONTANEOUS (miscarriage when she became sick from the first vaccine) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. Last menstrual period and estimated date of delivery were not provided. On an unknown date, the patient experienced ABORTION SPONTANEOUS (miscarriage when she became sick from the first vaccine) (seriousness criterion medically significant), ILLNESS (became sick from the first vaccine) and MATERNAL EXPOSURE DURING PREGNANCY (Maternal exposure during pregnancy). At the time of the report, ABORTION SPONTANEOUS (miscarriage when she became sick from the first vaccine) and ILLNESS (became sick from the first vaccine) outcome was unknown and MATERNAL EXPOSURE DURING PREGNANCY (Maternal exposure during pregnancy) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medications were reported. This case concerns of a female patient with no age and no relevant medical history reported who experienced the unexpected events of spontaneous abortion, illness and Maternal Exposure during pregnancy. The occurrence of these events are unknown as well as the time to onset from the vaccine administration with Moderna since the date of the first dose of the vaccine is also unknown. Other details of the pregnancy was also not reported like the LMP and EDD. The benefit-risk relationship of Spikevax is not affected by this report.; Sender''s Comments: This case concerns of a female patient with no age and no relevant medical history reported who experienced the unexpected events of spontaneous abortion, illness and Maternal Exposure during pregnancy. The occurrence of these events are unknown as well as the time to onset from the vaccine administration with Moderna since the date of the first dose of the vaccine is also unknown. Other details of the pregnancy was also not reported like the LMP and EDD. The benefit-risk relationship of Spikevax is not affected by this report.


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