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From the 5/14/2021 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 1022165



Case Details

VAERS ID: 1022165 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-01-21
Onset:2021-01-27
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027/L20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abortion induced, Abortion missed
SMQs:, Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PRENATAL VITAMINS, PROGESTERONE PESSARIES, ADDERALL, ASPIRIN
Current Illness: ANXIETY / DEPRESSION
Preexisting Conditions: ADD, ANXIETY, MIGRAINES,EXRECISE INDUCED ASTHMA CERVICAL DISC DEGENERATION.
Allergies: MONOCYCLINE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PATIENT HAD A MISSED ABORTION, FOUND OUT 6DAYS AFTER VACCINATION. HAD HISTORY OF PREVIOUS MISCARRIAGES. WAS ON PROGESTERONE PESSARIES AND ASPIRIN. FETAL HEART BEAT MISSING ON ROUTINE REVIEW. GESTATION 10WEEKS+4DAYS. REQUIRED MEDICAL TERMINATION OF PREGNANCY.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210514&IDNUMBER=1022165

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