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This is VAERS ID 1082804

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 1082804
VAERS Form:2
Age:28.0
Sex:Male
Location:Arizona
Vaccinated:2021-02-18
Onset:2021-03-02
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Completed suicide

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness: anxiety/depression
Preexisting Conditions: none known
Allergies: not known
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient committed suicide the morning of March 2, 2021. He stepped in front of a truck on a highway. I consulted with pharmacy and they said that I should report even if the 2 most likely have nothing to do with each other.


Changed on 5/7/2021

VAERS ID: 1082804 Before After
VAERS Form:2
Age:28.0
Sex:Male
Location:Arizona
Vaccinated:2021-02-18
Onset:2021-03-02
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Completed suicide

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness: anxiety/depression
Preexisting Conditions: none known
Allergies: not known known
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient committed suicide the morning of March 2, 2021. He stepped in front of a truck on a highway. I consulted with pharmacy and they said that I should report even if the 2 most likely have nothing to do with each other.


Changed on 5/14/2021

VAERS ID: 1082804 Before After
VAERS Form:2
Age:28.0
Sex:Male
Location:Arizona
Vaccinated:2021-02-18
Onset:2021-03-02
Submitted:0000-00-00
Entered:2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Completed suicide

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness: anxiety/depression
Preexisting Conditions: none known
Allergies: not known known
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient committed suicide the morning of March 2, 2021. He stepped in front of a truck on a highway. I consulted with pharmacy and they said that I should report even if the 2 most likely have nothing to do with each other.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1082804&WAYBACKHISTORY=ON

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