This is a passive reporting system, meaning it relies on individuals to send in reports of their experiences. This is is not designed to determine if a COVID19 vaccine caused a health problem, but is especially useful for detecting unusual or unexpected patterns of adverse event reporting that might indicate a possible safety problem with a vaccine.

This Form is only for the Philippines. We will not ask your personal data such as name, address, etc..
This is a private initiative and in no way related or affiliated to any government agencies.
you may contact us at vvicente@althash.org.

We will never share info. That by filling this up, you agree that the data you provide will solely be used for study and research purposes only and not to be disclosed to any other parties.

If you are experiencing a medical emergency, seek immediate assistance from a healthcare provider or call 9-1-1. We do not provide individual medical treatment, advice, or diagnosis. If you need individual medical or health care advice, consult a qualified healthcare provider.