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From the 12/31/2003 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 92803



Case Details

VAERS ID: 92803 (history)  
Form: Version .0  
Age: 36.3  
Sex: Female  
Location: California  
Vaccinated:1996-10-24
Onset:1996-10-25
   Days after vaccination:1
Submitted: 1996-11-05
   Days after onset:11
Entered: 1996-12-17
   Days after submission:42
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 / WYETH 4968145 / - - / -

Administered by: Private       Purchased by: Unknown
Symptoms: COORDINAT ABNORM, DEAF, TINNITUS
SMQs:

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 24OCT96 pt recv flu vax, woke up next morning w/dysequilibrium, tinnitus progressive hearing loss in one ear;profound sensorineural hearing loss;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=92803

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