Side effects Corona vaccination Rheinland-Pfalz

It is of great importance for medical research that as many people as possible report on your vaccination and the tolerability of the respective vaccine. Please document any vaccination reactions that may occur in the 21 days following your vaccination.

Please note: If you have been vaccinated through your family doctor, it is not possible to report side effects through this form.

All fields marked with * are mandatory and must be filled in.

Please enter the following personal information:

* First name

* Last name

* Date of birth

Please enter the data of the vaccination for which you would like to submit your report:

* Date

* Vaccine

* Vaccine dose

Vaccination number i

I did not receive a vaccination number as part of my vaccination because, for example, I was vaccinated via a mobile team

Please provide information on side effects below:

* Did you have any side effects?

yes

* Type of side effect

* Side effect location

* Severity

1 (light)

5 (heavy)

Unknown

* Date of first occurrence

* Duration in days

* Does the side effect still persist?

Yes

* Was treatment necessary?

Yes, with hospitalization

Yes, with outpatient treatment by a doctor

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