National Vaccine
Information Center
Your Health. Your Family. Your Choice.

 MedAlerts Home
Search Results

This is VAERS ID 107788

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 107788
VAERS Form:
Age:46.4
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1997-1998 / WYETH 4978184 / 0 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: DEAF

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 12/8/2009

VAERS ID: 107788 Before After
VAERS Form:
Age:46.4
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-24 1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1997-1998 INFLUENZA (SEASONAL) (FLUSHIELD 97-98) / WYETH WYETH PHARMACEUTICALS, INC 4978184 / 0 RA / IM

Administered by: Public      Purchased by: Unknown Private
Symptoms: Deafness, DEAF

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 8/31/2010

VAERS ID: 107788 Before After
VAERS Form:
Age:46.4
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 97-98) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4978184 / 0 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 7/7/2013

VAERS ID: 107788 Before After
VAERS Form:
Age:46.4
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 0 RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 0 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 2/14/2017

VAERS ID: 107788 Before After
VAERS Form:
Age:46.4 46.0
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 0 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 5/14/2017

VAERS ID: 107788 Before After
VAERS Form:
Age:46.0
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 0 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 9/14/2017

VAERS ID: 107788 Before After
VAERS Form:(blank) 1
Age:46.0
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 0 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 2/14/2018

VAERS ID: 107788 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 6/14/2018

VAERS ID: 107788 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 8/14/2018

VAERS ID: 107788 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 9/14/2018

VAERS ID: 107788 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 10/14/2018

VAERS ID: 107788 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 12/24/2020

VAERS ID: 107788 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

Changed on 12/30/2020

VAERS ID: 107788 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Colorado
Vaccinated:1997-10-15
Onset:1997-10-22
Submitted:1997-10-23
Entered:1998-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978184 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Deafness

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: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897314044L

Write-up: pt recv vax 15OCT97 & 7 days later pt devel deafness in lt ear;pt was seen by ENT specialist;multiple tests, including MRI were performed;results were not provided;reporter indicated event resulted in permanent disability;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=107788&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166