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From the 7/7/2013 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 84195



Case Details

VAERS ID: 84195 (history)  
Form: Version .0  
Age:   
Sex: Male  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1995-11-28
Entered: 1996-02-26
   Days after submission:90
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - - / IM

Administered by: Other       Purchased by: Other
Symptoms: Deafness, Myalgia, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 895347004L

Write-up: pt recv vax & devel tinnitus & unilateral sudden hearing loss that was classified as profound;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130707&IDNUMBER=84195

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