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From the 12/31/2003 release of VAERS data (an older release, current is 1/7/2022):

This is VAERS ID 166802

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Case Details

VAERS ID: 166802 (history)  
Form: Version .0  
Age: 48.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2000-10-16
Onset:2000-11-01
   Days after vaccination:16
Submitted: 2001-01-08
   Days after onset:68
Entered: 2001-03-12
   Days after submission:63
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE 00-01) /   U0346AA / 6 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: AMBLYOPIA, ASTHENIA, ATAXIA, BONE DIS, DEAF
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucophage, Norvasc, Multivitamins, Folic Acid; thiamine
Current Illness: NONE
Preexisting Conditions: NIDDM; HTN
Allergies:
Diagnostic Lab Data: CBC & Chem profile-WNL except WBC-18.8; Audiogram-showed sensorineural hearing loss;Xray-Cervical cord disc disease; lab work-(-); MRI- Acute demyelination disorder vs MS; EEG-(-); Lumbar Puncture-(-)
CDC Split Type:

Write-up: On 10/29/00 onset of nausea and dizziness while in shower, felt unsteady and off balance with whoring vertigo, bilateral tinnitus broke out in a cold sweat and vomited. On 10/30/00, had severe dizziness and was unable to walk without losing balance, veeri"ng off to sides. Seen by MD where I work and was given Vistaril IM for nausea and vomiting and scopolamine patches. On 11/2/00, seen in ER as there is no improvement and now also have blurry vision, no appetite with nausea and vomiting, severe tinnitus bi


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