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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1065910

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Case Details

VAERS ID: 1065910 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2020-12-30
Onset:2020-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]; BONJESTA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Miscarriage (18 May 2021); Pregnancy (live birth on 21 Feb 2016); Pregnancy (live birth on 08 Mar 2018)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Miscarriage; Received vaccine when pregnant; A spontaneous report was received from a 34-year old female patient who received Moderna''s COVID-19 Vaccine (mRNA-1273) when pregnant and experienced a miscarriage. The patient''s medical history included three prior pregnancies, with two live births and one miscarriage. Products known to have been used by the patient, within two weeks prior to the event, included prenatal vitamins and doxylamine succinate/pyridoxine hydrochloride. The patient received their first of two planned doses of mRNA-1273 (Batch number: 011J20A) on 30 Dec 2020. On 27 Jan 2021, the patient received their second of two planned doses of mRNA-1273 (Batch number: 028L20A) intramuscularly for prophylaxis of COVID-19 infection. At 7 weeks gestation, the fetus had a normal heart beat. She reported that she had no complications with the pregnancy. On 08 Feb 2021, the patient had a miscarriage. Treatment information was not provided. The patient received both scheduled doses of mRNA-1273; therefore, action taken with the drug in response to the event is not applicable. The events received vaccine when pregnant and miscarriage were considered recovered.; Reporter''s Comments: This report concerns a 34-year-old, P2G4 who experienced miscarriage 1 month 9 days post administration of first dose and 12 days after the last dose of mRNA-1273 vaccine. There is not enough information such as the last menstrual period, estimated date of conception and delivery and gestational age at the time of miscarriage. In addition, the patient''s detailed medical history including any trauma and reason for previous miscarriage is lacking. Vaccine exposure during pregnancy is assessed as not applicable.


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