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HRSA

The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, is the primary Federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable.

Below are links to frequently asked questions related to HRSA and the National Vaccine Injury Compensation Program.

Other Links:

Award amounts under VICP

Who may file a VICP claim?

Influenza Vaccines

Changes to the Vaccine Injury Table

Thimerosal Claims

NVICP Covered Vaccines

Vaccine Adverse Event Reporting System (VAERS)

NVICP Eligibility

Do I Qualify for the National Vaccine Compensation Program?

PERSONAL INFORMATION

First Name:

Last Name:

E-mail Address:

Address:

City:

State:

Zipcode:

Phone:

() - ext.

INJURED PERSON INFORMATION

Date of Birth:

For whom are you inquiring about?

If you are NOT inquiring on your own behalf, what is your relationship?

Is the person deceased?

Yes No

If deceased, the cause of death as stated on the death certificate:

Date of Death:

Was there an autopsy performed?

Yes No

INJURY INFORMATION

Has person had any of the following injuries within 48 hours of recieving the vaccination:

Encephalopathy
Stroke
Heart Attack
Brain Injury

Death
Seizure
Guillian-Barre Syndrome

DRUG INFORMATION

Has person had any of the following vaccinations:

Tetanus
Pertussis
Measles
Mumps
Chicken Pox (Varicella)
MMR
Rubella

Polio
Hepatitis B
Rotavirus (Rotashield)
Flu Shot
DTaP
DPT

Other:

Dates that Vaccine(s) were given?

Did behavior regress after receiving vaccines?

Yes No

If yes, please describe regressive behavior:

Other Information:

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Vaccine Attorney Disclaimer:This website is dedicated to providing public information regarding the Vaccine Injury Compensation Program and other legal information. None of the information on this site is intended to be formal legal advice, nor the formation of a lawyer or attorney client relationship. Please contact a Central Pennsylvania personal injury attorney or New Jersey Vaccine lawsuit lawyer at our law firm for information regarding your particular case. This website is not intended to solicit clients outside the States of New Jersey and Pennsylvania.