Vaccine incident report and reflection form
A vaccine incident report and reflection form to gather and document information required when a vaccine error or incident occurs.
Overview
All incidents/errors/near misses should be reported to your manager/organisation, and a local incident review should be undertaken to help understand what happened and how it can best be prevented in future.
Full information on the incident should be shared with your local Immunisation Coordinator. For a list of local Immunisation Coordinators click here. All reports will be treated in confidence.
Clinical advice can be provided by your Immunisation Coordinator or by calling 0800 IMMUNE (0800 466 863).
Click here for the new online vaccine incident report and reflection form.
This new streamlined, paperless process replaces previous paper-based forms and is designed to improve the efficiency, accuracy and accessibility of incident reporting. This form gathers all the necessary information to ensure appropriate and timely advice can be provided. Please remove all patient identifiable data when completing the form.
Key benefits:
- User-friendly – no printing, scanning, or emailing required
- Efficient and accurate – tick-box design enables quick and reliable data entry
- Centralised and secure – all reports are stored in one secure location
- Promotes safety and learning – helps identify gaps and supports continuous improvement
- After completing the new online form, a copy will be emailed to you for your records and can be retained in line with your incident management policy
From Monday 2 June, the NIP incident reporting form and email address, as well as the IMAC manual incident reporting form, will be retired.