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This is VAERS ID 1033516

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1033516
VAERS Form:2
Age:32.0
Sex:Female
Location:Minnesota
Vaccinated:2021-01-29
Onset:2021-02-15
Submitted:0000-00-00
Entered:2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Abortion spontaneous, Headache, Pain in extremity, Sleep disorder, Ultrasound scan vagina abnormal, Ultrasound abdomen abnormal, Exposure during pregnancy

Life Threatening? No
Birth Defect? Yes
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 multivitamin, iron supplement
Current Illness: On 1/20/2021 tested for Covid-19 via nasal swab due to having sore throat, fatigue, and headache. Test results came back negative that same day.
Preexisting Conditions: No chronic health issues, otherwise very healthy.
Allergies: NKA
Diagnostic Lab Data: On 2/16/21 I had an abdominal and vaginal ultrasounds, which confirmed absence of fetus in the uterus. Eptopic pregnancy was ruled out. MD was consulted on the same day regarding miscarriage.
CDC 'Split Type':

Write-up: At the time of administration of the first does of Moderna vaccine, I was 6 weeks pregnant. I had confirmed pregnancy with home positive test and missed period. I had an estimated due date of 9/24/2021. This was my 4th pregnancy. I have had two uncomplicated pregnancies to term. In September 2020 experienced a chemical pregnancy with early pregnancy loss at 5 weeks. The first 24 hours after 1st dose of vaccine I experienced extreme arm soreness in the arm that was vaccinated, causing headache and unable to sleep. After 24 hours I felt "normal". 2 weeks and 3 days following the first dose of Moderna, I had a miscarriage. On the night of 2/15/21 I lost the pregnancy with vaginal bleeding, bright red blood, passing tissue, clots/ sac. I had an uneventful pregnancy up to that point, feeling well as I had with prior pregnancies.


Changed on 5/7/2021

VAERS ID: 1033516 Before After
VAERS Form:2
Age:32.0
Sex:Female
Location:Minnesota
Vaccinated:2021-01-29
Onset:2021-02-15
Submitted:0000-00-00
Entered:2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Abortion spontaneous, Headache, Pain in extremity, Sleep disorder, Ultrasound scan vagina abnormal, Ultrasound abdomen abnormal, Exposure during pregnancy

Life Threatening? No
Birth Defect? Yes
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 multivitamin, iron supplement
Current Illness: On 1/20/2021 tested for Covid-19 via nasal swab due to having sore throat, fatigue, and headache. Test results came back negative that same day.
Preexisting Conditions: No chronic health issues, otherwise very healthy.
Allergies: NKA NKA
Diagnostic Lab Data: On 2/16/21 I had an abdominal and vaginal ultrasounds, which confirmed absence of fetus in the uterus. Eptopic pregnancy was ruled out. MD was consulted on the same day regarding miscarriage.
CDC 'Split Type':

Write-up: At the time of administration of the first does of Moderna vaccine, I was 6 weeks pregnant. I had confirmed pregnancy with home positive test and missed period. I had an estimated due date of 9/24/2021. This was my 4th pregnancy. I have had two uncomplicated pregnancies to term. In September 2020 experienced a chemical pregnancy with early pregnancy loss at 5 weeks. The first 24 hours after 1st dose of vaccine I experienced extreme arm soreness in the arm that was vaccinated, causing headache and unable to sleep. After 24 hours I felt "normal". 2 weeks and 3 days following the first dose of Moderna, I had a miscarriage. On the night of 2/15/21 I lost the pregnancy with vaginal bleeding, bright red blood, passing tissue, clots/ sac. I had an uneventful pregnancy up to that point, feeling well as I had with prior pregnancies.


Changed on 5/21/2021

VAERS ID: 1033516 Before After
VAERS Form:2
Age:32.0
Sex:Female
Location:Minnesota
Vaccinated:2021-01-29
Onset:2021-02-15
Submitted:0000-00-00
Entered:2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Abortion spontaneous, Headache, Pain in extremity, Sleep disorder, Ultrasound scan vagina abnormal, Ultrasound abdomen abnormal, Exposure during pregnancy

Life Threatening? No
Birth Defect? Yes
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 multivitamin, iron supplement
Current Illness: On 1/20/2021 tested for Covid-19 via nasal swab due to having sore throat, fatigue, and headache. Test results came back negative that same day.
Preexisting Conditions: No chronic health issues, otherwise very healthy.
Allergies: NKA NKA
Diagnostic Lab Data: On 2/16/21 I had an abdominal and vaginal ultrasounds, which confirmed absence of fetus in the uterus. Eptopic pregnancy was ruled out. MD was consulted on the same day regarding miscarriage.
CDC 'Split Type':

Write-up: At the time of administration of the first does of Moderna vaccine, I was 6 weeks pregnant. I had confirmed pregnancy with home positive test and missed period. I had an estimated due date of 9/24/2021. This was my 4th pregnancy. I have had two uncomplicated pregnancies to term. In September 2020 experienced a chemical pregnancy with early pregnancy loss at 5 weeks. The first 24 hours after 1st dose of vaccine I experienced extreme arm soreness in the arm that was vaccinated, causing headache and unable to sleep. After 24 hours I felt "normal". 2 weeks and 3 days following the first dose of Moderna, I had a miscarriage. On the night of 2/15/21 I lost the pregnancy with vaginal bleeding, bright red blood, passing tissue, clots/ sac. I had an uneventful pregnancy up to that point, feeling well as I had with prior pregnancies.

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