If an individual suffers a Serious Adverse Event causing permanent impairment or death associated with a Vaccine, they (or in the event of their death, a legal heir, parent, guardian or other legal representative of that individual) can apply for compensation under the COVID-19 Vaccine Facility No-Fault Compensation Scheme.
If you think you have, or a person you are authorised to represent has, suffered a Serious Adverse Event associated with a Vaccine that has resulted in such an Injury or death, you may complete and submit either an online or paper Claim Form, by following the instructions contained in the links below in order to make a claim for compensation.
There you will also find detailed instructions explaining how to submit your Claim and any additional documents that must be submitted with your Claim.
Complete the Online Claim Form to apply for compensation.
Print, upload and submit the Supporting Evidence Form and other documents that are required to be submitted together with the Claim Form
If you have downloaded and printed a paper copy of your Claim Form, it can be uploaded and submitted here.
A serious untoward medical occurrence that (i) is sustained or suffered by a Patient following the administration of a Vaccine, and (ii) results in an Injury, as evidenced by the supporting evidence, using the form in Schedule 3 of the Scheme’s Protocol, required to evaluate a Claim and that shall include:
A COVID-19 vaccine received in any Participating Country that is either: (i) procured and/or delivered by UNICEF on a Participating Country's behalf; (ii) donated to a Participating Country through UNICEF; or (iii) formally included into the Scheme (but otherwise procured and/or delivered but not by or through UNICEF), that:
- either (A) has licensure or authorisation from a stringent (“functional”) regulatory authority or (B) has received WHO prequalification, following licensure or authorisation from a stringent (“functional”) regulatory authority, or (C) has been issued authorisation for emergency use based on licensure or authorisation by a stringent (“functional”) regulatory authority; and
- is included in Schedule 1 of the Scheme’s Protocol, as updated from time to time; and
- has received all required approvals and authorisations for importation, distribution and use in the relevant country; and
- has not reached its Scope of Coverage Endpoint.
The Covid-19 Vaccine Facility No-Fault Compensation Scheme, established to provide fair compensation to eligible vaccine recipients who suffer a Serious Adverse Event related to a COVID-19 vaccination that has been either:
- procured and/or delivered by UNICEF on a Participating Country’s behalf;
- donated to a Participating Country through UNICEF; or
- formally included into the Scheme (but otherwise procured and/or delivered but not by or through UNICEF),
as detailed in the Scheme Protocol and its Schedules.
Serious bodily injury or illness suffered or sustained by a Patient that:
- requires Hospitalisation or prolongs an existing Hospitalisation; and
- results in permanent total or partial Impairment; or
- is a congenital birth injury or illness in an unborn or new-born child of a woman who received a Vaccine and results in permanent total or partial Impairment; or
- results in death.
A written claim for compensation completed by a Claimant, using the Claim Form approved by and provided by the Administrator, as set forth in Schedule 2 of the Scheme’s Protocol, which must be accompanied by all Supporting Evidence.
The supporting evidence, using the form in Schedule 3 of the Scheme’s Protocol, required to evaluate a Claim and that shall include:
- detailed medical documentation from a Registered Healthcare Professional describing the Injury and medical treatment required as a result of the Injury, together with details of any Hospitalisation or prolonged Hospitalisation, including but not limited to admission and discharge records;
- a description of the nature, extent, functional impact and prognosis of the Injury, as assessed by the Registered Healthcare Professional.
- a statement from the Registered Healthcare Professional that the Injury was, in the Registered Healthcare Professional’s opinion, the result of the Vaccine or its administration;
- certification from a Registered Healthcare Professional of when, where and which Vaccine was administered;
- in the case of death, a death certificate and any other documentation available from a Registered Healthcare Professional of the cause and manner of death; and
- any further evidence that the Administrator may deem necessary to adjudicate the Claim and/or Receivable Claim, as applicable, guided, as appropriate, by the Scientific Advisory Committee, the Review Panel, and/or the Appeals Panel.