Help us find VAERS records that have been deleted (or messed around with)
An informal project by Brianne Dressen (react19.org) and Glenn Chan (LongHaulWiki.com).
Sign in to Google to save your progress. Learn more
Your e-reporting number.  This is usually the first number that you get from VAERS.
Your VAERS number, if you have it. 
If you're not sure whether your number is an e-reporting number or your VAERS number, use the next question.
Not sure if it's your VAERS number or e-reporting number?  Put it here.
IMPORTANT!!!  We need some way of contacting you so that we can get your permission to report issues to the FDA.  Without a way of connecting the report to a human, the FDA may be able to argue that the report is fake.  Please leave your email, reddit/forum username, etc.
 *
To see what's in your public VAERS record, go to https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1760638&WAYBACKHISTORY=ON and change the IDNUMBER in the middle.  See the image below
If your record was deleted, the website was say that your record was deleted (in red text).
Was your record removed from VAERS?
Clear selection
If they messed around with your VAERS report, you can leave some brief comments here.
Some people find that their VAERS report doesn't match what they told VAERS.
Thank you!  Please remember to click submit below
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms