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From the 11/19/2021 release of VAERS data:

This is VAERS ID 916065

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Case Details

VAERS ID: 916065 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Washington  
Vaccinated:2020-12-27
Onset:2020-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Exposure during pregnancy, Foetal monitoring, Hydrops foetalis, Premature labour
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zofran 2weeks prior, Multivatamins
Current Illness: none
Preexisting Conditions:
Allergies: Sulfa, Vicodin, Neosporin
Diagnostic Lab Data:
CDC Split Type:

Write-up: EDD - 4/1/2021 - Contractions at 26 w 3 days sent to L&D to be monitored on 12/28/20. Covid-19 Sars Vaccine given 1st dose 12/27/20. Patient was diagnosed with Fetal Hydrops. Patient Hospitalized 12/28/20 - current MFM consulting in hospital & outpatient


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