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This is VAERS ID 1457452

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1457452
VAERS Form:2
Age:54.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-04-10
Onset:2021-04-12
Submitted:0000-00-00
Entered:2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Completed suicide, Suicidal ideation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-29
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: tizanidine, hydrocodone/acetaminophen, lisinopril, midodrine, esomeprazole, trazodone, valacyclovir, tramadol, metoprolol, mirtazapine, venlafaxine, gabapentin, baclofen, atorvastatin, mirtazapine, tolterodine, ondansetron, ciprofloxacin,
Current Illness:
Preexisting Conditions: Multiple sclerosis, cardiomyopathy, depression
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Completed suicide on 04/29/2021. Family reported an increase in suicidal ideations after the vaccination.

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