This is a brief 5 question survey being conducted by Beth Clay. The results will be posted on her website and a link provided on Facebook. Please take a few minutes to respond and share a link to survey with your contacts. The survey will be active beginning August 1, 2017.  Thank you for your assistance.

* 1. Have you or a member of your immediate family (child, spouse, parent) ever suffered a suspected adverse reaction to a vaccine?

* 2. After the suspected vaccine reaction, did you call your doctor's office, go to an emergency room, or seek medical input in any way?

* 3. In looking back, did the health professionals you interacted with document and report to the FDA the suspected vaccine adverse event? (FDA manages the MEDWatch system and the VAERS system, both of which are avenues to report adverse reactions.)

* 4. Please describe briefly the vaccine adverse event including age of individual, type of reaction, and how the medical professionals involved responded.

* 5. For demographic purposes only, please list the state you lived in at the time (or country if outside of the USA).

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