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This is VAERS ID 107150

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 107150
VAERS Form:
Age:50.6
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1997-1998 / CONNAUGHT LABS 7F81895 / - - / -
PPV: PNU-IMUNE(R)23 / LEDERLE 444069 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: INFECT, DEAF, MALAISE, TINNITUS

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI negative;
CDC 'Split Type':

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;


Changed on 12/8/2009

VAERS ID: 107150 Before After
VAERS Form:
Age:50.6
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-05 1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1997-1998 INFLUENZA (SEASONAL) (FLUZONE 97-98) / CONNAUGHT LABS CONNAUGHT LABORATORIES 7F81895 / - - / -
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 444069 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Deafness, Infection, Malaise, Tinnitus, INFECT, DEAF, MALAISE, TINNITUS

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI negative;
CDC 'Split Type': (blank) 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;


Changed on 8/31/2010

VAERS ID: 107150 Before After
VAERS Form:
Age:50.6
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 97-98) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81895 / - - / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 444069 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Deafness, Infection, Malaise, Tinnitus

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:
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;


Changed on 7/7/2013

VAERS ID: 107150 Before After
VAERS Form:
Age:50.6
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81895 / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81895 / - - / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 444069 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Deafness, Infection, Malaise, Tinnitus

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:
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;


Changed on 2/14/2017

VAERS ID: 107150 Before After
VAERS Form:
Age:50.6 50.0
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81895 / - - / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 444069 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Deafness, Infection, Malaise, Tinnitus

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:
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;


Changed on 5/14/2017

VAERS ID: 107150 Before After
VAERS Form:
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81895 / - - / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 444069 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Deafness, Infection, Malaise, Tinnitus

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: ~ ()~~~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;


Changed on 9/14/2017

VAERS ID: 107150 Before After
VAERS Form:(blank) 1
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
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

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: ~ ()~~~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;


Changed on 2/14/2018

VAERS ID: 107150 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
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

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: ~ ()~~~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;


Changed on 6/14/2018

VAERS ID: 107150 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
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

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: ~ ()~~~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;


Changed on 8/14/2018

VAERS ID: 107150 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
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

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: ~ ()~~~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;


Changed on 9/14/2018

VAERS ID: 107150 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
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

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: ~ ()~~~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;


Changed on 10/14/2018

VAERS ID: 107150 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
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

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: ~ ()~~~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;


Changed on 12/24/2020

VAERS ID: 107150 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
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

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: ~ ()~~~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;


Changed on 12/30/2020

VAERS ID: 107150 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:1997-11-14
Onset:1998-01-10
Submitted:1998-01-30
Entered:1998-02-03
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

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: ~ ()~~~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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