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You can use the form below to report possible vaccination damage. After you have submitted this form, a specialist will contact you.

Consumers – The Netherlands

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Step 1 of 4

25%

How many vaccinations have you had?

Hoeveel vaccinaties heeft u gehad?

Which vaccinations have you had?

Vaccination 1

Vaccination 2

Vaccination 3

Vaccination 4

Vaccination 5

Which side effects are you having?

Bijwerkingen

Inflammation of the heart muscle / pericardium (myocarditis/pericarditis) from the first injection up to a month after the second injection.

Unexplained acute cardiac arrest from the first injection up to and including four weeks after the last injection.

Clotting problems from the first injection up to two weeks after the last injection.

Inflammation of the blood vessels (vasculitis) from the first injection up to two weeks after the last injection.

Inflammation of the nerves (Guillain-Barre Syndrome) from the first injection up to two weeks after the last injection.

Serious skin problems from the first injection up to two weeks after the last injection.

Serious allergic reaction (anaphylaxis) immediately after the first or second injection.

Blue, painful fingers or toes from the first injection up to two weeks after the last injection.

Serious clotting problems resulting in thrombosis and a reduced platelet count (lung embolism, sinus thrombosis, thrombosis of the leg) within a month after the injection.

Inflammation of the spinal cord (myelitis transversa) within a month after the injection.

Inflammation of the nerves (Guillain-Barre Syndrome) within a month after the injection.

Capillary leak syndrome (weight gain, swollen arms and legs and low blood pressure).

Serious allergic reaction after the injection.

If your complaint is not on the list, then please send an e-mail to meldingen@vaccinclaim.com

How can the law firm contact you?

First name

Surname

E-mail address*

Telephone*

Initiator

VaccinClaim.com
is an initiative set up by
Stichting Vaccinatieveiligheid

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