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VAERS ID: 1307657

AGE: 17| SEX: M|State: OH

Description

Death by suicide.

Symptoms

Completed suicide

Vaccines

VAX DATE: 18 April 2021 | ONSET DATE: 22 April 2021 | DAYS TO ONSET: 4
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • EW0153

RECVDATE:10 May 2021
CAGE_YR:17
CAGE_MO:
RPT_DATE:
DIED:Y
DATEDIED:22 April 2021
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:N
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:None
CUR_ILL:none
HISTORY:none
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:10 May 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:none
V_FUNDBY:
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