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This is VAERS ID 69853

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 69853
VAERS Form:
Age:71.6
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1994-1995 / CONNAUGHT LABS 4F51088 / 8 LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: FEVER, PAIN BACK, DEAF, MYALGIA, LARYNGITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': mild anemia;

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 12/8/2009

VAERS ID: 69853 Before After
VAERS Form:
Age:71.6
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
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 4F51088 / 8 LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia, FEVER, PAIN BACK, DEAF, MYALGIA, LARYNGITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': mild anemia; (blank)

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 8/31/2010

VAERS ID: 69853 Before After
VAERS Form:
Age:71.6
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 94-95) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 8 LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 7/7/2013

VAERS ID: 69853 Before After
VAERS Form:
Age:71.6
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 8 LA / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 8 LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 2/14/2017

VAERS ID: 69853 Before After
VAERS Form:
Age:71.6 71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 8 LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 5/14/2017

VAERS ID: 69853 Before After
VAERS Form:
Age:71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 8 LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none; none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 9/14/2017

VAERS ID: 69853 Before After
VAERS Form:(blank) 1
Age:71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 8 7+ LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 2/14/2018

VAERS ID: 69853 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 7+ LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 6/14/2018

VAERS ID: 69853 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 7+ LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 8/14/2018

VAERS ID: 69853 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 7+ LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 9/14/2018

VAERS ID: 69853 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 7+ LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 10/14/2018

VAERS ID: 69853 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 7+ LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 12/24/2020

VAERS ID: 69853 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 7+ LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 12/30/2020

VAERS ID: 69853 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 7+ LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 5/7/2021

VAERS ID: 69853 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 7+ LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;


Changed on 5/14/2021

VAERS ID: 69853 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Massachusetts
Vaccinated:1994-11-01
Onset:1994-11-02
Submitted:1994-12-11
Entered:1994-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F51088 / 7+ LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=69853&WAYBACKHISTORY=ON


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