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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 102181



Case Details

VAERS ID: 102181 (history)  
Form: Version .0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:1996-11-04
Onset:1996-11-05
   Days after vaccination:1
Submitted: 1997-05-16
   Days after onset:191
Entered: 1997-09-11
   Days after submission:118
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 / WYETH 4968201 / - - / -

Administered by: Other       Purchased by: Unknown
Symptoms: DYSPHAGIA, EYE DIS, LACRIMATION DIS, PARALYSIS FACIAL
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: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1 days p/vax pt devel Bell''s Palsy;As of 7MAY97 pt still exp facial paralysis, lt eye watered & would not close & had diff chewing & eating;no further info was available @ the date of this report;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=102181

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