From the 12/31/2003 release of VAERS data (an older release, current is 1/15/2021):

This is VAERS ID 26637

Case Details

VAERS ID:	26637 (history)
Form:	Version .0
Age:
Sex:	Male
Location:	Iowa

Vaccinated:	1990-09-27
Onset:	0000-00-00
Submitted:	0000-00-00
Entered:	1990-11-15

Vaccination / Manufacturer	Lot / Dose	Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS	- / -	- / -
PPV: PNU-IMUNE(R)23 / LEDERLE	268982 / -	- / -

Administered by: Unknown Purchased by: Unknown
Symptoms: MYALGIA, PAIN NECK, PARALYSIS FACIAL
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:
Current Illness:
Preexisting Conditions: Prior to onset of Bell''s Palsy, pt had been aware of some myalgia & just not feeling quite right, also experienced mild pain in the neck.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with Pneumococcal/Influenza developed symptoms of Bell''s Palsy. Prior to onset of Bell''s Palsy, pt had myalgia, mild pain in the neck & generally not feeling quite right.

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