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This is VAERS ID 105336

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 105336
VAERS Form:
Age:85.9
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1997-1998 / CONNAUGHT LABS 7F81840 / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: DEAF TRANS PART

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type': hypothyroid condition

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 12/8/2009

VAERS ID: 105336 Before After
VAERS Form:
Age:85.9
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-05 1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1997-1998 INFLUENZA (SEASONAL) (FLUZONE 97-98) / CONNAUGHT LABS CONNAUGHT LABORATORIES 7F81840 / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Deafness transitory, DEAF TRANS PART

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type': hypothyroid condition (blank)

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 8/31/2010

VAERS ID: 105336 Before After
VAERS Form:
Age:85.9
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 97-98) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 7/7/2013

VAERS ID: 105336 Before After
VAERS Form:
Age:85.9
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 2/14/2017

VAERS ID: 105336 Before After
VAERS Form:
Age:85.9 85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 5/14/2017

VAERS ID: 105336 Before After
VAERS Form:
Age:85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 9/14/2017

VAERS ID: 105336 Before After
VAERS Form:(blank) 1
Age:85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 2/14/2018

VAERS ID: 105336 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 6/14/2018

VAERS ID: 105336 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 8/14/2018

VAERS ID: 105336 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 9/14/2018

VAERS ID: 105336 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 10/14/2018

VAERS ID: 105336 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 12/24/2020

VAERS ID: 105336 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 12/30/2020

VAERS ID: 105336 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 5/7/2021

VAERS ID: 105336 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;


Changed on 5/14/2021

VAERS ID: 105336 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:New York
Vaccinated:1997-09-16
Onset:1997-09-17
Submitted:1997-11-28
Entered:1997-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81840 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Deafness transitory

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Synthroid once/day
Current Illness: NONE
Preexisting Conditions: hypothyroid condition
Allergies:
Diagnostic Lab Data: both tests indicated significant hearing loss bilat;standard hearing test X3;BAER test brain stem auditory response test;
CDC 'Split Type':

Write-up: w/in 24hr of vax pt exp hearing related sx in both ears;voices are heard @ two distinct pitches @ the same time-a nl pitch & a very low pitch;marked hearing loss;inability to recognize familiar voices;singing voices sound off key;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=105336&WAYBACKHISTORY=ON


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