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This is VAERS ID 1121867

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1121867
VAERS Form:2
Age:32.0
Sex:Female
Location:New York
Vaccinated:2021-02-01
Onset:2021-03-19
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, Ultrasound antenatal screen, Laboratory test, Anembryonic gestation

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 5/7/2021

VAERS ID: 1121867 Before After
VAERS Form:2
Age:32.0
Sex:Female
Location:New York
Vaccinated:2021-02-01
Onset:2021-03-19
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, Ultrasound antenatal screen, Laboratory test, Anembryonic gestation

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Vitamins
Current Illness: None
Preexisting Conditions: History of thrombosis
Allergies: None 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.


Changed on 5/21/2021

VAERS ID: 1121867 Before After
VAERS Form:2
Age:32.0
Sex:Female
Location:New York
Vaccinated:2021-02-01
Onset:2021-03-19
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, Ultrasound antenatal screen, Laboratory test, Anembryonic gestation

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Vitamins
Current Illness: None
Preexisting Conditions: History of thrombosis
Allergies: None 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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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=1121867&WAYBACKHISTORY=ON


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