Acute Events following Immunisation to COVID-19
Use this online form to report adverse events following immunisation to COVID-19, where symptom onset is within 72 hours of vaccination
|This form does not replace the need to report suspected adverse events following immunisation to COVID-19 via the Yellow Card scheme.|
If you have already reported using the Yellow Card system, then use this form to provide additional information which will be submitted to the NHS COVID-19 Vaccine programme.
If you have not yet reported to the MHRA, then complete this proforma and at the end, the system will generate a summary which can be copied into the Yellow Card form (and other reporting systems). You will need to enter the MHRA report number prior to final submission.
This system is a collaboration between Public Health England, NHSE and MHRA. PHE is the data owner and controller, and is authorised under Regulation 3 and 7 of the Health Service (Control of Patient Information) Regulations 2002 to collect the data (including personal identifiables [PII]) requested below.