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VAERS ID: 1243487

AGE: 17| SEX: M|State: MI

Description

Patient Committed Suicide with a firearm.

Symptoms

Completed suicide

Vaccines

VAX DATE: 12 April 2021 | ONSET DATE: 20 April 2021 | DAYS TO ONSET: 8
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 1
  • IM
  • LA
  • EW010

RECVDATE:21 April 2021
CAGE_YR:17
CAGE_MO:
RPT_DATE:
DIED:Y
DATEDIED:20 April 2021
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:N
LAB_DATA:None
V_ADMINBY:UNK
OTHER_MEDS:Unknown, History of Mental Illness
CUR_ILL:Mental Illness,
HISTORY:Mental Illness
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:21 April 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:None Reported
V_FUNDBY:
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