PrototypeSynthetic data only. This is a demonstration built for a CDC RFQ response. It is not a CDC system and is not connected to VAERS. Do not enter real personal or health information.
Vaccine Adverse Event Reporting — Prototype

Demonstration build — Miranium AI LLC response to CDC RFQ 75D301-26-Q-00146

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Questions and answers

Plain-language answers about what to report and how the form works. These entries are editable by programme staff in the content admin — the same entries also power the assistant inside the report form.

Showing 12 of 12 questions.

  • What should I report?

    Report any health problem that happened after a vaccination, even if you are not sure the vaccine caused it. Reviewers look for patterns across many reports — you do not need to prove a connection, and you will not be penalised for reporting something that turns out to be unrelated.

    Written for: Public reporters and Healthcare providers

  • I am not sure what counts as a reaction. What do I do?

    Describe what you noticed in your own words — sore arm, fever, rash, feeling faint, anything that seemed out of the ordinary. There is no minimum severity. If it is not on the tick-list, write it in the description box.

    Written for: Public reporters

  • What if I do not know the exact dates?

    Give your best estimate. The vaccination date is usually printed on the vaccination card or the pharmacy receipt. If the onset date is approximate, say so in the description box.

    Written for: Public reporters and Healthcare providers

  • How do I report a vaccine administration error?

    Choose the report type that matches: an error with an adverse event, or an error where no adverse event was observed. If no adverse event occurred, the form removes every adverse-event question and asks only about the error itself.

    Written for: Healthcare providers

  • Which documents should I attach?

    Attach whatever helps a reviewer understand what happened: the vaccination record or card, discharge paperwork if there was a hospital or emergency visit, and any test or laboratory results. The form suggests specific records based on your answers.

    Written for: Public reporters and Healthcare providers

  • Can I upload a photo of my vaccination card?

    Not in Phase 1. This release accepts medical and vaccine records as documents — PDF, Word, text, RTF, CSV and clinical exchange formats. Image upload, including photographs of vaccination cards, is the Phase 2 extension. If you only have a photo, describe what it shows in the free-text box for now.

    Written for: Public reporters and Healthcare providers

  • What happens to the information I enter here?

    Nothing. This is a demonstration prototype built for a procurement response. It is not connected to VAERS or to any CDC system, it stores synthetic demonstration records only, and you should not enter real personal or health information.

    Written for: Public reporters and Healthcare providers

  • What counts as a serious outcome?

    Death, a life-threatening event, hospitalisation or a longer hospital stay, permanent disability, or a birth defect. Ticking one of these does not claim the vaccine caused it — it tells reviewers how serious the outcome was so the report is prioritised.

    Written for: Public reporters and Healthcare providers

  • Can I report on behalf of someone else?

    Yes. Parents, carers and family members can report for another person, and healthcare providers can report for their patients. Choose the option that matches at the start of the form.

    Written for: Public reporters

  • What happens after I submit?

    In the production system the report is assigned an identifier, screened for serious outcomes, and made available to safety reviewers; serious reports get follow-up. In this prototype, submitting shows you the VAERS-shaped record your answers produced and stops there.

    Written for: Public reporters and Healthcare providers

  • I cannot find the lot number. Can I still report?

    Yes. The lot number helps reviewers link reports to a specific batch, but it is optional. Leave it blank if you do not have the vaccination card to hand.

    Written for: Public reporters and Healthcare providers

  • Can I add information later?

    In the production system, yes — reports can be supplemented with follow-up information and additional documents. This prototype demonstrates the initial submission only.

    Written for: Public reporters and Healthcare providers

Still stuck?

The report form has an assistant panel that answers questions in context and can take you straight to the relevant step. Open the report form.