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Report an Adverse Event

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Please report all significant adverse events that occur after vaccination of adults and children, even if you are not sure whether the vaccine caused the adverse event. The Vaccine Adverse Event Reporting System (VAERS) accepts all reports, including reports of vaccination errors.

Guidance on reporting vaccination errors is available if you have additional questions.

 There are three ways to report to VAERS-  
  1. Online
  2. Fax
  3. Mail

Information identifying the person who received the vaccine and the person who filed the report is not made available to the public. You or your health care provider may be contacted for further information after your report is received.

Knowingly filing a false VAERS report with the intent to mislead the Department of Health and Human Services is a violation of Federal law (18 U.S. Code § 1001) punishable by fine and imprisonment.

The US Food and Drug Administration has issued new regulations for vaccine manufacturers subject to mandatory reporting requirements, "Postmarketing Safety Reports for Human Drug and Biologic Products; Electronic Submission Requirements", which describes requirements for electronic submission of Individual Case Safety Reports (ICSRs), ICSR attachments and periodic reports to FDA by the manufacturer.  For more information about electronic ICSR reporting to eVAERS, vaccine manufacturers should refer to the FDA ICSR website: http://www.fda.gov/BiologicsBloodVaccines/DevelopmentApprovalProcess/ucm174963.htm or contact the FDA Electronic Submissions Help Desk at: esgprep@fda.hhs.gov.

Report Online

Report by Fax

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Report by Mail

  • Mail a completed VAERS Form to VAERS, P.O. Box 1100, Rockville, MD 20849-1100. A pre-paid postage stamp is included on the back of the form.

  • Download the VAERS Form (PDF-98.5 KB).

  • Request a VAERS form by sending e-mail to info@vaers.org, by calling (800) 822-7967, or by faxing a request to (877) 721-0366.

  • Before you begin review the Instructions for Completing the VAERS Paper Form

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