Report an Adverse Event
en Español
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. VAERS is primarily concerned with monitoring adverse health events and we encourage reporting of clinically significant adverse health events following vaccination. Using clinical judgment, healthcare professionals can decide whether or not to report a medical error at their own discretion. For example, a healthcare professional may elect to report vaccination errors that do not have an associated adverse health event, especially if they think the vaccination error may pose a safety risk (e.g., administering a live vaccine to an immunocompromised patient) or that the error would be preventable with public health action or education.
There are three ways to report to VAERS-
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.
Report Online
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Complete a VAERS On-Line Form on this site.
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Before you begin review the Instructions for Completing the VAERS On-Line Form. Please note that thet VAERS On-Line form has a 20 minute limit to complete each of the steps. Your information will be erased if you timeout and you will be returned to Step 1; you will receive a warning after 15 minutes.
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Information supplied in the online submission form is transmitted securely to VAERS. Visit the VAERS Privacy Policies and Disclaimers section for more information about Secure Sockets Layer and data transmission.
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Report by Fax
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Fax a completed VAERS Form to (877) 721-0366.
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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.
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Before you begin review the Instructions for Completing the VAERS Paper Form.
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Report by Mail
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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.
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Download the VAERS Form (PDF-98.5 KB).
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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.
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Before you begin review the Instructions for Completing the VAERS Paper Form.
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