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))
        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: