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This is VAERS ID 1002168

History of Changes from the VAERS Wayback Machine

First Appeared on 2/12/2021

VAERS ID: 1002168
VAERS Form:2
Age:31.0
Sex:Female
Location:Connecticut
Vaccinated:2021-01-10
Onset:2021-02-02
Submitted:0000-00-00
Entered:2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Ultrasound antenatal screen abnormal, Vaginal haemorrhage, Foetal heart rate abnormal, Exposure during pregnancy

Life Threatening? No
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)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Magnesium, vit d, prenatal vitamin, vit c
Current Illness: None
Preexisting Conditions: PCOS, high cholesterol
Allergies: None
Diagnostic Lab Data: 2/2/2021- in office transabdominal umtrasound, revealed no fetal heart beat . Scheduled d&c/s 2/5/2021
CDC 'Split Type':

Write-up: 2nd pregnancy, at date of first dose (1/10/2021), 12 weeks 3 days gestation. on 2/2/2021 patient developed light vaginal bleeding. Ultrasound exam revealed no fetal heartbeat. Measurements showed gestational size 14 weeks 1 day (1/22/2021).


Changed on 5/7/2021

VAERS ID: 1002168 Before After
VAERS Form:2
Age:31.0
Sex:Female
Location:Connecticut
Vaccinated:2021-01-10
Onset:2021-02-02
Submitted:0000-00-00
Entered:2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Ultrasound antenatal screen abnormal, Vaginal haemorrhage, Foetal heart rate abnormal, Exposure during pregnancy

Life Threatening? No
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)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Magnesium, vit d, prenatal vitamin, vit c
Current Illness: None
Preexisting Conditions: PCOS, high cholesterol
Allergies: None None
Diagnostic Lab Data: 2/2/2021- in office transabdominal umtrasound, revealed no fetal heart beat . Scheduled d&c/s 2/5/2021
CDC 'Split Type':

Write-up: 2nd pregnancy, at date of first dose (1/10/2021), 12 weeks 3 days gestation. on 2/2/2021 patient developed light vaginal bleeding. Ultrasound exam revealed no fetal heartbeat. Measurements showed gestational size 14 weeks 1 day (1/22/2021).


Changed on 5/14/2021

VAERS ID: 1002168 Before After
VAERS Form:2
Age:31.0
Sex:Female
Location:Connecticut
Vaccinated:2021-01-10
Onset:2021-02-02
Submitted:0000-00-00
Entered:2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Ultrasound antenatal screen abnormal, Vaginal haemorrhage, Foetal heart rate abnormal, Exposure during pregnancy

Life Threatening? No
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)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Magnesium, vit d, prenatal vitamin, vit c
Current Illness: None
Preexisting Conditions: PCOS, high cholesterol
Allergies: None None
Diagnostic Lab Data: 2/2/2021- in office transabdominal umtrasound, revealed no fetal heart beat . Scheduled d&c/s 2/5/2021
CDC 'Split Type':

Write-up: 2nd pregnancy, at date of first dose (1/10/2021), 12 weeks 3 days gestation. on 2/2/2021 patient developed light vaginal bleeding. Ultrasound exam revealed no fetal heartbeat. Measurements showed gestational size 14 weeks 1 day (1/22/2021).

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=1002168&WAYBACKHISTORY=ON

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