| | 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. |
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