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This is VAERS ID 975155

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 975155
VAERS Form:2
Age:25.0
Sex:Female
Location:Kansas
Vaccinated:2020-12-22
Onset:2021-01-20
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, Pregnancy test, Progesterone, Human chorionic gonadotropin, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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


Changed on 5/7/2021

VAERS ID: 975155 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Kansas
Vaccinated:2020-12-22
Onset:2021-01-20
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, Pregnancy test, Progesterone, Human chorionic gonadotropin, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none 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


Changed on 5/14/2021

VAERS ID: 975155 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Kansas
Vaccinated:2020-12-22
Onset:2021-01-20
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, Pregnancy test, Progesterone, Human chorionic gonadotropin, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none 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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