Lagos State, Nigeria
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LAGOS VACCINATION BOOKING
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VACCINE TRACKER
Report Side-Effect
Please Provide this Information
Booking ID
Reaction Name
Please Select
Injection site pain and swelling
Fatigue
Headache
Chills
Fever
Muscle and joint pain
Nausea
Redness or a rash at the injection site
Swollen lymph nodes
Other
Reaction Name
Injection site pain and swelling
Fatigue
Headache
Chills
Fever
Muscle and joint pain
Nausea
Redness or a rash at the injection site
Swollen lymph nodes
Other
Effect/ Reaction as Reported)
Outcome of Reaction
Please Select
Recovered/Resolved
Recovering/Resolving
Recovered/Resolved with sequelae
Not Recovered/Not Resolved
Fatal
Unknown
Reaction Treatment
Please Select
No Treatment
Non-Medical Treatment
Medical Treatment
Dialysis
Surgery
Unknown
Did reaction abate after usage Stop or reduce?
Please select
Yes
No
Did Reaction Appear after Reintroduction
Please select
Yes
No
Serious
Please select
Yes
No
Onset Date
End Date
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