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This is VAERS ID 91555

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 91555
VAERS Form:
Age:56.9
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 / WYETH 4968188 / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: DEAF, TINNITUS

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 12/8/2009

VAERS ID: 91555 Before After
VAERS Form:
Age:56.9
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-06 1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 INFLUENZA (SEASONAL) (FLUSHIELD 96-97) / WYETH WYETH PHARMACEUTICALS, INC 4968188 / - - / -

Administered by: Other      Purchased by: Unknown Private
Symptoms: Deafness, Tinnitus, DEAF, TINNITUS

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 8/31/2010

VAERS ID: 91555 Before After
VAERS Form:
Age:56.9
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 96-97) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4968188 / - - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 7/7/2013

VAERS ID: 91555 Before After
VAERS Form:
Age:56.9
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / - - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 2/14/2017

VAERS ID: 91555 Before After
VAERS Form:
Age:56.9 56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / - - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 5/14/2017

VAERS ID: 91555 Before After
VAERS Form:
Age:56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / - - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 9/14/2017

VAERS ID: 91555 Before After
VAERS Form:(blank) 1
Age:56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / - UNK - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 2/14/2018

VAERS ID: 91555 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / UNK - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 6/14/2018

VAERS ID: 91555 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / UNK - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 8/14/2018

VAERS ID: 91555 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / UNK - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 9/14/2018

VAERS ID: 91555 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / UNK - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 10/14/2018

VAERS ID: 91555 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / UNK - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 12/24/2020

VAERS ID: 91555 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / UNK - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 12/30/2020

VAERS ID: 91555 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / UNK - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 5/7/2021

VAERS ID: 91555 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / UNK - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;


Changed on 5/14/2021

VAERS ID: 91555 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:California
Vaccinated:1996-09-21
Onset:1996-09-21
Submitted:1996-10-15
Entered:1996-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968188 / UNK - / -

Administered by: Other      Purchased by: Private
Symptoms: Deafness, Tinnitus

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: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: MRI, ear exam, blood work
CDC 'Split Type':

Write-up: pt recv vax 1PM 21SEP96 & later had an eye exam & went home;about 4PM took a nap;around 5PM woke up lt ear was ringing loudly about 6PM pt daughter called & pt stated could not hear at all from left ear;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=91555&WAYBACKHISTORY=ON


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