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This is VAERS ID 987914

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 987914
VAERS Form:2
Age:33.0
Sex:Female
Location:Iowa
Vaccinated:2021-01-22
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Abortion spontaneous, Back pain, Ultrasound scan, Blood test, Exposure during pregnancy

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, 200 mg Progesterone
Current Illness: Subchorionic hematoma, diagnosed by ultrasound on 1/19/2021
Preexisting Conditions: GERD
Allergies: None
Diagnostic Lab Data: Bloodwork and Ultrasound done 1/26/2020 in ER after miscarriage, have follow up appt with OBGYN on 2/15
CDC 'Split Type':

Write-up: Received COVID vaccine on Friday afternoon, 1/22, developed some slight abdominal cramping 1/24 and 1/25, had severe abdominal and back pain resulting in miscarriage evening of 1/25. Estimated date of delivery: August 27, 2020 Also had known subchorionic hematoma, diagnosed on 1/19 via ultrasound at physician''s (OBGYN) office


Changed on 5/7/2021

VAERS ID: 987914 Before After
VAERS Form:2
Age:33.0
Sex:Female
Location:Iowa
Vaccinated:2021-01-22
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Abortion spontaneous, Back pain, Ultrasound scan, Blood test, Exposure during pregnancy

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, 200 mg Progesterone
Current Illness: Subchorionic hematoma, diagnosed by ultrasound on 1/19/2021
Preexisting Conditions: GERD
Allergies: None None
Diagnostic Lab Data: Bloodwork and Ultrasound done 1/26/2020 in ER after miscarriage, have follow up appt with OBGYN on 2/15
CDC 'Split Type':

Write-up: Received COVID vaccine on Friday afternoon, 1/22, developed some slight abdominal cramping 1/24 and 1/25, had severe abdominal and back pain resulting in miscarriage evening of 1/25. Estimated date of delivery: August 27, 2020 Also had known subchorionic hematoma, diagnosed on 1/19 via ultrasound at physician''s (OBGYN) office


Changed on 5/14/2021

VAERS ID: 987914 Before After
VAERS Form:2
Age:33.0
Sex:Female
Location:Iowa
Vaccinated:2021-01-22
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Abortion spontaneous, Back pain, Ultrasound scan, Blood test, Exposure during pregnancy

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, 200 mg Progesterone
Current Illness: Subchorionic hematoma, diagnosed by ultrasound on 1/19/2021
Preexisting Conditions: GERD
Allergies: None None
Diagnostic Lab Data: Bloodwork and Ultrasound done 1/26/2020 in ER after miscarriage, have follow up appt with OBGYN on 2/15
CDC 'Split Type':

Write-up: Received COVID vaccine on Friday afternoon, 1/22, developed some slight abdominal cramping 1/24 and 1/25, had severe abdominal and back pain resulting in miscarriage evening of 1/25. Estimated date of delivery: August 27, 2020 Also had known subchorionic hematoma, diagnosed on 1/19 via ultrasound at physician''s (OBGYN) office

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