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This is VAERS ID 1243487

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1243487
VAERS Form:2
Age:17.0
Sex:Male
Location:Michigan
Vaccinated:2021-04-13
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW010 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-21
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: Unknown, History of Mental Illness
Current Illness: Mental Illness,
Preexisting Conditions: Mental Illness
Allergies: None Reported
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient Committed Suicide with a firearm.

Changed on 5/7/2021

VAERS ID: 1243487 Before After
VAERS Form:2
Age:17.0
Sex:Male
Location:Michigan
Vaccinated:2021-04-13
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW010 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-21
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: Unknown, History of Mental Illness
Current Illness: Mental Illness,
Preexisting Conditions: Mental Illness
Allergies: None Reported Reported
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient Committed Suicide with a firearm.

Changed on 5/14/2021

VAERS ID: 1243487 Before After
VAERS Form:2
Age:17.0
Sex:Male
Location:Michigan
Vaccinated:2021-04-13
Onset:2021-04-21
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW010 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-21
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: Unknown, History of Mental Illness
Current Illness: Mental Illness,
Preexisting Conditions: Mental Illness
Allergies: None Reported Reported
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient Committed Suicide with a firearm.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1243487&WAYBACKHISTORY=ON


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