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Adverse Events Following Immunization Reporting Form

Quick Links to Reporting Forms

See Also

(Previously known as Vaccine Associated Adverse Event Reporting Form)

General Information

The Public Health Agency of Canada collects case reports on adverse events following immunization from provincial and territorial health departments, health care professionals and the pharmaceutical industry.

The data is stored in the Canadian Adverse Events Following Immunization (CAEFI) database and is used to signal adverse events that may require more in-depth investigation. The main function of the Canadian Adverse Events Following Immunization Surveillance System (CAEFISS) is to ensure the continued safety of vaccines on the Canadian market by monitoring adverse events following immunization with vaccines.

How to Report

For health care professionals
If a patient experiences an adverse event following immunization, please complete the Adverse Events Following Immunization (AEFI) Form and send it to the local heath department, or send it directly to the Public Health Agency of Canada by fax at 613-946-0244, or by mail using the address indicated at the upper right hand corner of the form.

For the General Public
Should you experience an adverse event following immunization, please ask your doctor, nurse, or pharmacist to complete the Adverse Events following Immunization (AEFI) Form.

Adverse Events Following Immunization Form
PDF Version PDF (2 Pages, 344 KB)

Reporting adverse reactions to drugs and other health products

To report adverse reactions to drugs and other health products visit:

Health Canada’s Marketed Health Products Directorate (MHPD) new window