Guided workflow

Complete the steps with fictional people and products. The form will not accept this as official VAERS intake.

Step 1 of 6

1. Who is reporting?
2. Reporter contact
3. Patient (synthetic)
4. Vaccine details
5. What happened?
6. Review and submit

Who is reporting?

The workflow branches here. Public reporters describe a suspected event. Healthcare providers can also file a vaccine error with no adverse event.

Reporter pathway

Public / consumerA member of the public reporting a suspected adverse event after vaccination.Healthcare providerA clinician or immunization staff member. Unlocks the vaccine-error branch.

Reviewers can load a clearly labeled synthetic sample instead of typing.