Healthcare Practitioner’s Vaccine Error Reporting Form

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Use the form below to report  an error or hazard to the ISMP National Vaccine Errors Reporting Program

If you want to report a non-preventable adverse reaction to a vaccine product, please visit the US Department of Health and Human Services Vaccine Adverse Event Reporting System (VAERS) (
Report submission type

Vaccine(s) involved in this event

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'Remove' will remove all of the added vaccines.