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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 943837

Case Details

VAERS ID: 943837 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Haemorrhage, Human chorionic gonadotropin negative, Ultrasound scan vagina abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levetiracetam 500mg , Folic acid 4mg, prenatal vitamin, vitamin C 500mg, Zinc 50mg, Omega 3 fatty acids
Current Illness:
Preexisting Conditions: Seizure disorder
Allergies: Amoxicillin
Diagnostic Lab Data: 1/13/2021: Intravaginal ultrasound showing no gestational sac or embryo which would have been expected for gestation 1/13/2021: Hcg, Total, Quantitative 971 mIU/mL
CDC Split Type:

Write-up: Approximately 5 days after administration at 6 weeks pregnant, I began bleeding. The following day (6 days after administration) miscarriage was confirmed via ultrasound

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