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History of Changes from the VAERS Wayback Machine |
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?IDNUMBER=107150&WAYBACKHISTORY=ON
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