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This is VAERS ID 917350

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 917350
VAERS Form:2
Age:20.0
Sex:Female
Location:Wyoming
Vaccinated:2020-12-26
Onset:2020-12-27
Submitted:0000-00-00
Entered:2021-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abortion spontaneous, Dizziness, Fatigue, Malaise, Pregnancy test positive, Ultrasound scan, Foetal heart rate abnormal, Impaired work ability, Injection site swelling, Injection site discomfort, Blood test, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood work and ultrasound - emergency dept.
CDC 'Split Type':

Write-up: 27Dec2020 - patient developed some swelling (went about 1 inch out from injection site) and discomfort at the injection site - had taken Advil and was using a cool compress. 29Dec2020 - patient had to leave work early since she was not feeling well - very fatigued and a little dizzy (able to eat/drink) - denied any COVID illness s/s (no cough, fever, loss of taste/smell, etc). She ended up going to the local ED - since she was still very fatigued and was feeling like she was going to pass out - blood work and U/S done - this is where she found out she had been pregnant but had lost the pregnancy (no heart beat). Per her report - all other blood work was unremarkable. No other medications given to her during this visit and was just told that she would be ''passing the products of conception within this next week''.


Changed on 5/7/2021

VAERS ID: 917350 Before After
VAERS Form:2
Age:20.0
Sex:Female
Location:Wyoming
Vaccinated:2020-12-26
Onset:2020-12-27
Submitted:0000-00-00
Entered:2021-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abortion spontaneous, Dizziness, Fatigue, Malaise, Pregnancy test positive, Ultrasound scan, Foetal heart rate abnormal, Impaired work ability, Injection site swelling, Injection site discomfort, Blood test, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: Blood work and ultrasound - emergency dept.
CDC 'Split Type':

Write-up: 27Dec2020 - patient developed some swelling (went about 1 inch out from injection site) and discomfort at the injection site - had taken Advil and was using a cool compress. 29Dec2020 - patient had to leave work early since she was not feeling well - very fatigued and a little dizzy (able to eat/drink) - denied any COVID illness s/s (no cough, fever, loss of taste/smell, etc). She ended up going to the local ED - since she was still very fatigued and was feeling like she was going to pass out - blood work and U/S done - this is where she found out she had been pregnant but had lost the pregnancy (no heart beat). Per her report - all other blood work was unremarkable. No other medications given to her during this visit and was just told that she would be ''passing the products of conception within this next week''.


Changed on 5/14/2021

VAERS ID: 917350 Before After
VAERS Form:2
Age:20.0
Sex:Female
Location:Wyoming
Vaccinated:2020-12-26
Onset:2020-12-27
Submitted:0000-00-00
Entered:2021-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abortion spontaneous, Dizziness, Fatigue, Malaise, Pregnancy test positive, Ultrasound scan, Foetal heart rate abnormal, Impaired work ability, Injection site swelling, Injection site discomfort, Blood test, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: Blood work and ultrasound - emergency dept.
CDC 'Split Type':

Write-up: 27Dec2020 - patient developed some swelling (went about 1 inch out from injection site) and discomfort at the injection site - had taken Advil and was using a cool compress. 29Dec2020 - patient had to leave work early since she was not feeling well - very fatigued and a little dizzy (able to eat/drink) - denied any COVID illness s/s (no cough, fever, loss of taste/smell, etc). She ended up going to the local ED - since she was still very fatigued and was feeling like she was going to pass out - blood work and U/S done - this is where she found out she had been pregnant but had lost the pregnancy (no heart beat). Per her report - all other blood work was unremarkable. No other medications given to her during this visit and was just told that she would be ''passing the products of conception within this next week''.

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