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From the 5/7/2021 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 1090217



Case Details

VAERS ID: 1090217 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-02-04
Onset:2021-02-22
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abortion spontaneous, Heart rate, Investigation, Laboratory test, Ultrasound scan
SMQs:, Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D; FOLATE; ZOLOFT
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210203; Test Name: heartbeat; Result Unstructured Data: Test Result:152 bpm; Test Date: 20210220; Test Name: heartbeat; Result Unstructured Data: Test Result:no heartbeat detected; Test Date: 20210203; Test Name: hormone levels; Result Unstructured Data: Test Result:normal ranges. No issues detected.; Test Date: 20210203; Test Name: OB exam; Result Unstructured Data: Test Result:showed healthy baby at 7w5d; Test Date: 20210203; Test Name: Labs; Result Unstructured Data: Test Result:normal ranges. No issues detected.; Test Date: 20210203; Test Name: ultrasound; Result Unstructured Data: Test Result:no abnormalities identified; Test Date: 20210220; Test Name: ultrasound; Result Unstructured Data: Test Result:fetus stopped growing on 09Feb21 (8w4d)
CDC Split Type: USPFIZER INC2021204433

Write-up: Miscarriage; This is a Spontaneous report from a contactable consumer (patient). This consumer reported information for both mother and fetus. This is the maternal report. A 39-year-old female consumer reported that a 39-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot number: EL9269), via an unspecified route of administration at left arm on 04Feb2021 14:00 at a single dose for COVID-19 immunization. Medical history included allergies: Penicillin. No other vaccine in four weeks. Concomitant medications included (in two weeks) Prenatal vitamin, colecalciferol (VITAMIN D), folic acid (FOLATE) and sertraline hydrochloride (ZOLOFT 25mg). The patient''s last menstrual date was 14Dec2020 and the delivery date was on 17Sep2021 (Gestational period: 8, as reported). An OB exam on 03Feb2021 showed healthy baby at 7w5d- heartbeat detected 152bpm; no abnormalities identified via ultrasound, Labs and hormone levels all within normal ranges. No issues detected. Mother received 1st dose of vaccine 04Feb2021. Per ultrasound on 20Feb2021, fetus stopped growing on 09Feb2021 (8w4d); no heartbeat detected. Miscarriage occurred 22Feb2021. AE resulted in Emergency room/department or urgent care, congenital anomaly (as reported). No treatment was administered. No COVID prior vaccination. Patient not COVID tested post vaccination. The outcome of the event was not recovered.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021225027 fetus case


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210507&IDNUMBER=1090217

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