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This is VAERS ID 1010113

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/5/2021

VAERS ID: 1010113
VAERS Form:2
Age:28.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-01-07
Onset:2021-01-21
Submitted:0000-00-00
Entered:2021-02-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abortion spontaneous

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? No
Previous Vaccinations:
Other Medications: Prenatal vitamin, Diclegis
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Fetal U/S on 2/4
CDC 'Split Type':

Write-up: Miscarriage - first vaccine at 10 weeks and 3 days with prior proof of heartbeat/movement, second vaccine at 13 weeks and 3 days; learned of miscarriage at 14 weeks 3 days with measurements of 12 weeks 3 days on U/S


Changed on 5/7/2021

VAERS ID: 1010113 Before After
VAERS Form:2
Age:28.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-01-07
Onset:2021-01-21
Submitted:0000-00-00
Entered:2021-02-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abortion spontaneous

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? No
Previous Vaccinations:
Other Medications: Prenatal vitamin, Diclegis
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: Fetal U/S on 2/4
CDC 'Split Type':

Write-up: Miscarriage - first vaccine at 10 weeks and 3 days with prior proof of heartbeat/movement, second vaccine at 13 weeks and 3 days; learned of miscarriage at 14 weeks 3 days with measurements of 12 weeks 3 days on U/S


Changed on 5/21/2021

VAERS ID: 1010113 Before After
VAERS Form:2
Age:28.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-01-07
Onset:2021-01-21
Submitted:0000-00-00
Entered:2021-02-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abortion spontaneous

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? No
Previous Vaccinations:
Other Medications: Prenatal vitamin, Diclegis
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: Fetal U/S on 2/4
CDC 'Split Type':

Write-up: Miscarriage - first vaccine at 10 weeks and 3 days with prior proof of heartbeat/movement, second vaccine at 13 weeks and 3 days; learned of miscarriage at 14 weeks 3 days with measurements of 12 weeks 3 days on U/S

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