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This is VAERS ID 69850

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 69850
VAERS Form:
Age:55.5
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1994-1995 / CONNAUGHT LABS 4F51145 / 0 LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: HYPOKINESIA, DEAF, ASTHENIA, PAIN EAR

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 12/8/2009

VAERS ID: 69850 Before After
VAERS Form:
Age:55.5
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-29 1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1994-1995 INFLUENZA (SEASONAL) (FLUZONE 94-95) / CONNAUGHT LABS CONNAUGHT LABORATORIES 4F51145 / 0 LA / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia, HYPOKINESIA, DEAF, ASTHENIA, PAIN EAR

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 8/31/2010

VAERS ID: 69850 Before After
VAERS Form:
Age:55.5
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 94-95) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 0 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 7/7/2013

VAERS ID: 69850 Before After
VAERS Form:
Age:55.5
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 0 LA / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 0 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 2/14/2017

VAERS ID: 69850 Before After
VAERS Form:
Age:55.5 55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 0 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 5/14/2017

VAERS ID: 69850 Before After
VAERS Form:
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 0 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 9/14/2017

VAERS ID: 69850 Before After
VAERS Form:(blank) 1
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 0 1 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 2/14/2018

VAERS ID: 69850 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 1 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 6/14/2018

VAERS ID: 69850 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 1 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 8/14/2018

VAERS ID: 69850 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 1 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 9/14/2018

VAERS ID: 69850 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 1 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 10/14/2018

VAERS ID: 69850 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 1 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 12/24/2020

VAERS ID: 69850 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 1 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 12/30/2020

VAERS ID: 69850 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 1 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 5/7/2021

VAERS ID: 69850 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 1 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;


Changed on 5/14/2021

VAERS ID: 69850 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:New Jersey
Vaccinated:1994-11-10
Onset:1994-11-11
Submitted:1994-12-20
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51145 / 1 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Deafness, Ear pain, Hypokinesia

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: none;
Current Illness:
Preexisting Conditions: pcn, ASA;
Allergies:
Diagnostic Lab Data: none;
CDC 'Split Type':

Write-up: pt recvd vax;day p/ vax,became weak & sluggish;about 1 1/2 wk p/vax,lost hearing rt ear accompanied by pain;now main problem is hearing loss of rt ear;

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