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

Adverse event report

Report what happened after a vaccination

This is a demonstration. Use made-up names and details — nothing here is sent to CDC or VAERS.

Who is filling in this report?

Both paths collect the same underlying data. What changes is the wording, the help text, and which questions are asked at all.

You can switch between the two paths at any point in this demonstration — your answers are kept, and you can watch the same data element change its wording.