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

This is VAERS ID 975155



Case Details

VAERS ID: 975155 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Kansas  
Vaccinated:2020-12-22
Onset:2021-01-20
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J202A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Human chorionic gonadotropin, Pregnancy test, Progesterone
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: prenatal vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 01/20/2021- quantitative hcg 17, progesterone 0.2 01/22/2021- quantitative hcg 11, progesterone 0.1
CDC Split Type:

Write-up: LMP was 12/15/2020. Vaccine given on 12/22/2020. 3 positive pregnancy tests on 01/16/2021. Miscarried on 01/20/2021 as confirmed by serial quantitative hcg testing. Estimated 4-5WGA. Expectant management at home only


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