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From the 1/7/2022 release of VAERS data:

This is VAERS ID 1121867

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Case Details

VAERS ID: 1121867 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-01
Onset:2021-03-19
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abortion spontaneous, Anembryonic gestation, Laboratory test, Ultrasound antenatal screen
SMQs:, Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Vitamins
Current Illness: None
Preexisting Conditions: History of thrombosis
Allergies: None
Diagnostic Lab Data: Ultrasound ER visit Labwork
CDC Split Type:

Write-up: Received COVID vaccine on 1Feb2021 and was currently seeking to become pregnant. I concieved a child on 2Feb2021-4Feb2021. On 19March2021 it was determined that the pregnancy was abnormal and that I had miscarried, with likely diagnosis of blighted ovum.


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