Interactive Prototype — Tab 2-2. Demonstration of the proposed modernized VAERS reporting experience. Synthetic data only — no live systems, no personal data, nothing is submitted. Prepared by Idealistic Solutions LLC for Solicitation 75D301-26-Q-00146.

Vaccine Adverse Event Reporting System Modernized Reporting Prototype — HHS · CDC

Report an adverse event following vaccination — made simpler

This redesigned experience guides every submitter through exactly the questions that apply to them. Choose the path that describes you, and the form adapts as you answer.

Not sure? — the wizard will route you correctly.

Path A Members of the public

Patients, parents, caregivers, and family members. Simple language, no medical coding knowledge needed, optional fields clearly marked.

  • Plain-language questions, one topic per step
  • Save-and-return preview (shown in the guide)
  • Free-text box for anything we didn't ask

Path B Healthcare providers

Clinics, pharmacies, and hospitals. Structured clinical capture, facility details, and professional terminology — with smart defaults from your profile (simulated).

  • Clinical detail: vaccine lot, onset interval, outcome
  • Facility & NPI pre-fill from simulated profile
  • Supplemental document suggestions

Frequently asked questions

Ask a question in place — the reactive assistant answers from this list without leaving the page.

Data & downloads

VAERS summary dataSimulated dataset (CSV) — prototype sample Report form (printable)Reference copy of the data elements captured Reporting guideWho should report, and what happens next

Downloads in this prototype return a generated sample document, clearly labelled as synthetic. In production these would link the live VAERS data services.