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History of Changes from the VAERS Wayback Machine |
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?IDNUMBER=107788&WAYBACKHISTORY=ON
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