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This is VAERS ID 37917

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 37917
VAERS Form:
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 / WYETH 4818127 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: DEAF, VERTIGO, VESTIBUL DIS, REACT AGGRAV

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;


Changed on 12/8/2009

VAERS ID: 37917 Before After
VAERS Form:
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-17 1991-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) / WYETH WYETH PHARMACEUTICALS, INC 4818127 / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Condition aggravated, Deafness, Vertigo, Vestibular disorder, DEAF, VERTIGO, VESTIBUL DIS, REACT AGGRAV

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 891291023L

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;


Changed on 8/31/2010

VAERS ID: 37917 Before After
VAERS Form:
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4818127 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Deafness, Vertigo, Vestibular disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891291023L

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;


Changed on 7/7/2013

VAERS ID: 37917 Before After
VAERS Form:
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4818127 / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4818127 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Deafness, Vertigo, Vestibular disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891291023L

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;


Changed on 12/14/2016

VAERS ID: 37917 Before After
VAERS Form:
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4818127 / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4818127 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Deafness, Vertigo, Vestibular disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891291023L

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;


Changed on 5/14/2017

VAERS ID: 37917 Before After
VAERS Form:
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4818127 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Deafness, Vertigo, Vestibular disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891291023L

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;


Changed on 9/14/2017

VAERS ID: 37917 Before After
VAERS Form:(blank) 1
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4818127 / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Deafness, Vertigo, Vestibular disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891291023L

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;


Changed on 2/14/2018

VAERS ID: 37917 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4818127 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Deafness, Vertigo, Vestibular disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891291023L

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;


Changed on 6/14/2018

VAERS ID: 37917 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4818127 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Deafness, Vertigo, Vestibular disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891291023L

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;


Changed on 8/14/2018

VAERS ID: 37917 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4818127 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Deafness, Vertigo, Vestibular disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891291023L

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;


Changed on 9/14/2018

VAERS ID: 37917 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4818127 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Deafness, Vertigo, Vestibular disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891291023L

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;


Changed on 10/14/2018

VAERS ID: 37917 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Maryland
Vaccinated:1991-09-03
Onset:1991-09-19
Submitted:1991-09-19
Entered:1991-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4818127 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Deafness, Vertigo, Vestibular disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Salutensin, Theodur, Ventolin, Azmacort, Xanax;
Current Illness: NONE
Preexisting Conditions: pt has hx of hearing loss (wears 2 hearing aids), dizziness, hypertension, chronic obstructive pulmonary disease, & benign prostatic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891291023L

Write-up: Pt w/a long-standing hx of severe hearing impairment, claimed exp inc hearing loss 16 days p/recvd flu vax; On 24SEP91 pt c/o vertigo & poss Meniere''s disease;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=37917&WAYBACKHISTORY=ON


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