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From the 4/30/2021 release of VAERS data:

This is VAERS ID 107150



Case Details

VAERS ID: 107150 (history)  
Form: Version 1.0  
Age: 50.0  
Sex: Male  
Location: Michigan  
Vaccinated:1997-11-14
Onset:1998-01-10
   Days after vaccination:57
Submitted: 1998-01-30
   Days after onset:20
Entered: 1998-02-03
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81895 / UNK - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 444069 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Deafness, Infection, Malaise, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI negative;
CDC Split Type: CO7833

Write-up: pt recv vax 14NOV97 & some unspecified time p/vax pt c/o not feeling well x 1wk;10JAN98 c/o 85% hearing loss, 4JAN97 ringing ear approx 5 wk p/vax;concerned w/viral inj;MRI negative;


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