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From the 10/8/2021 release of VAERS data:

This is VAERS ID 987914



Case Details

VAERS ID: 987914 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-01-22
Onset:2021-01-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Abortion spontaneous, Back pain, Blood test, Exposure during pregnancy, Ultrasound scan
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic 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? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, 200 mg Progesterone
Current Illness: Subchorionic hematoma, diagnosed by ultrasound on 1/19/2021
Preexisting Conditions: GERD
Allergies: None
Diagnostic Lab Data: Bloodwork and Ultrasound done 1/26/2020 in ER after miscarriage, have follow up appt with OBGYN on 2/15
CDC Split Type:

Write-up: Received COVID vaccine on Friday afternoon, 1/22, developed some slight abdominal cramping 1/24 and 1/25, had severe abdominal and back pain resulting in miscarriage evening of 1/25. Estimated date of delivery: August 27, 2020 Also had known subchorionic hematoma, diagnosed on 1/19 via ultrasound at physician''s (OBGYN) office


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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=987914

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