Submitting treatment injury claims for COVID-19 vaccine reactions
We encourage health professionals to submit a treatment injury claim for all severe reactions to the COVID-19 vaccine, particularly for cases of myocarditis and pericarditis which in Aotearoa is most commonly associated with Pfizer mRNA vaccine.
If the claim is accepted, we can support your patient to recover from their injury. This might include treatment, weekly compensation, or rehabilitation support.
Claims can be submitted at any time following the reaction – there is no time limit.
To submit a treatment injury claim:
- Complete an ACC2152 treatment injury claim form and an electronic or manual ACC45 injury claim form. To help with reporting, ACC needs to know the COVID-19 vaccine brand name and vaccination dose number (i.e., first, second, booster).
- You can note this on:
- the ACC45: Tick the treatment injury box. Identify this as an adverse event in the drop-down menu. Then enter the COVID-19 vaccine brand name and vaccination dose number in the open comments section
- the ACC2152: In Section 3 – Treatment claimed to have caused the injury.
- When lodging a claim for a physical injury, please identify the specific injury, for example ‘myocarditis’, – not just the symptoms.
- Always attach the completed ACC2152 form.
