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This is VAERS ID 58363

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 58363
VAERS Form:
Age:28.0
Sex:Female
Location:Ohio
Vaccinated:1991-12-06
Onset:1991-12-18
Submitted:1993-11-23
Entered:1993-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1993-1994 / PARKE-DAVIS - / - RA / IM

Administered by: Other      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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax 6DEC91 & 18DEC91 devel hearing loss in lt ear; 27JAN93 dx w/profound sensorineural hearing loss of the lt ear; hearing loss cont to the date of this report;


Changed on 12/8/2009

VAERS ID: 58363 Before After
VAERS Form:
Age:28.0
Sex:Female
Location:Ohio
Vaccinated:1991-12-06
Onset:1991-12-18
Submitted:1993-11-23
Entered:1993-12-23 1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1993-1994 INFLUENZA (SEASONAL) (FLUOGEN 93-94) / PARKE-DAVIS - / - RA / IM

Administered by: Other      Purchased by: Unknown Other
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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 893336014J

Write-up: pt recvd vax 6DEC91 & 18DEC91 devel hearing loss in lt ear; 27JAN93 dx w/profound sensorineural hearing loss of the lt ear; hearing loss cont to the date of this report;


Changed on 8/31/2010

VAERS ID: 58363 Before After
VAERS Form:
Age:28.0
Sex:Female
Location:Ohio
Vaccinated:1991-12-06
Onset:1991-12-18
Submitted:1993-11-23
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 93-94) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - RA / IM

Administered by: Other      Purchased by: Other
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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893336014J

Write-up: pt recvd vax 6DEC91 & 18DEC91 devel hearing loss in lt ear; 27JAN93 dx w/profound sensorineural hearing loss of the lt ear; hearing loss cont to the date of this report;


Changed on 7/7/2013

VAERS ID: 58363 Before After
VAERS Form:
Age:28.0
Sex:Female
Location:Ohio
Vaccinated:1991-12-06
Onset:1991-12-18
Submitted:1993-11-23
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - RA / IM

Administered by: Other      Purchased by: Other
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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893336014J

Write-up: pt recvd vax 6DEC91 & 18DEC91 devel hearing loss in lt ear; 27JAN93 dx w/profound sensorineural hearing loss of the lt ear; hearing loss cont to the date of this report;


Changed on 5/14/2017

VAERS ID: 58363 Before After
VAERS Form:
Age:28.0
Sex:Female
Location:Ohio
Vaccinated:1991-12-06
Onset:1991-12-18
Submitted:1993-11-23
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - RA / IM

Administered by: Other      Purchased by: Other
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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893336014J

Write-up: pt recvd vax 6DEC91 & 18DEC91 devel hearing loss in lt ear; 27JAN93 dx w/profound sensorineural hearing loss of the lt ear; hearing loss cont to the date of this report;


Changed on 9/14/2017

VAERS ID: 58363 Before After
VAERS Form:(blank) 1
Age:28.0
Sex:Female
Location:Ohio
Vaccinated:1991-12-06
Onset:1991-12-18
Submitted:1993-11-23
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - UNK RA / IM

Administered by: Other      Purchased by: Other
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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893336014J

Write-up: pt recvd vax 6DEC91 & 18DEC91 devel hearing loss in lt ear; 27JAN93 dx w/profound sensorineural hearing loss of the lt ear; hearing loss cont to the date of this report;


Changed on 2/14/2018

VAERS ID: 58363 Before After
VAERS Form:1
Age:28.0
Sex:Female
Location:Ohio
Vaccinated:1991-12-06
Onset:1991-12-18
Submitted:1993-11-23
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK RA / IM

Administered by: Other      Purchased by: Other
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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893336014J

Write-up: pt recvd vax 6DEC91 & 18DEC91 devel hearing loss in lt ear; 27JAN93 dx w/profound sensorineural hearing loss of the lt ear; hearing loss cont to the date of this report;


Changed on 6/14/2018

VAERS ID: 58363 Before After
VAERS Form:1
Age:28.0
Sex:Female
Location:Ohio
Vaccinated:1991-12-06
Onset:1991-12-18
Submitted:1993-11-23
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK RA / IM

Administered by: Other      Purchased by: Other
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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893336014J

Write-up: pt recvd vax 6DEC91 & 18DEC91 devel hearing loss in lt ear; 27JAN93 dx w/profound sensorineural hearing loss of the lt ear; hearing loss cont to the date of this report;


Changed on 8/14/2018

VAERS ID: 58363 Before After
VAERS Form:1
Age:28.0
Sex:Female
Location:Ohio
Vaccinated:1991-12-06
Onset:1991-12-18
Submitted:1993-11-23
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK RA / IM

Administered by: Other      Purchased by: Other
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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893336014J

Write-up: pt recvd vax 6DEC91 & 18DEC91 devel hearing loss in lt ear; 27JAN93 dx w/profound sensorineural hearing loss of the lt ear; hearing loss cont to the date of this report;


Changed on 9/14/2018

VAERS ID: 58363 Before After
VAERS Form:1
Age:28.0
Sex:Female
Location:Ohio
Vaccinated:1991-12-06
Onset:1991-12-18
Submitted:1993-11-23
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK RA / IM

Administered by: Other      Purchased by: Other
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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893336014J

Write-up: pt recvd vax 6DEC91 & 18DEC91 devel hearing loss in lt ear; 27JAN93 dx w/profound sensorineural hearing loss of the lt ear; hearing loss cont to the date of this report;


Changed on 10/14/2018

VAERS ID: 58363 Before After
VAERS Form:1
Age:28.0
Sex:Female
Location:Ohio
Vaccinated:1991-12-06
Onset:1991-12-18
Submitted:1993-11-23
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK RA / IM

Administered by: Other      Purchased by: Other
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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893336014J

Write-up: pt recvd vax 6DEC91 & 18DEC91 devel hearing loss in lt ear; 27JAN93 dx w/profound sensorineural hearing loss of the lt ear; hearing loss cont to the date of this report;

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