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  • (aefi) Reporting Form - Nsw Health - Health Nsw Gov

Get (aefi) Reporting Form - Nsw Health - Health Nsw Gov

Office Use Only National Adverse Events Following Immunisation (AEFI) Reporting Form Date Report Received: Notification ID: Vaccinated person s details Vaccination provider details Personal details:.

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Any adverse event listed in the VAERS Table of Reportable Events Following Vaccination that occurs within the specified time period after vaccination. An adverse event listed by the vaccine manufacturer as a contraindication to further doses of the vaccine.

ACT: ACT Health Department 02 6205 2300. NSW: 1300 066 055 (to connect to your local public health unit) NT: NT Department of Health 08 8922 8044. Qld: Queensland Health 07 3328 9888, or complete an AEFI initial report form on the Queensland Health website.

Reporting Directly to the FDA: There are three options for submitting a voluntary report: 1) Complete Form 3500 online at www.accessdata.fda.gov/scripts/medwatch; 2) call 1-800-FDA-1088 to report by telephone; and 3) download a copy of Form 3500 at www.fda.gov/downloads/Safety/MedWatch/DownloadForms/UCM082725.pdf and ...

For more information, call the VAERS Information Line at (800) 822-7967 or send an email to info@vaers.org.

The Vaccine Adverse Event Reporting System (VAERS) database contains information on unverified reports of adverse events (illnesses, health problems and/or symptoms) following immunization with US-licensed vaccines. Reports are accepted from anyone and can be submitted electronically at www.vaers.hhs.gov.

Common AEFI Seen 7 10 days after vaccination: Fever (can be >39.4 C), lasting 2 3 days, faint red rash (not infectious), head cold and/or runny nose, cough and/or puffy eyes. Drowsiness or tiredness. Swelling of salivary glands.

An Adverse event following immunization (AEFI) is any untoward medical occurrence which follows immunization and which does not necessarily have a causal relationship with the usage of the vaccine. The adverse event may be any unfavourable or unintended sign, abnormal laboratory finding, symptom or disease.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232