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Information for
Influenza
Vaccine Recipients

Thank you for your interest in
sharing your flu
vaccine
experience;
the
information you
provide will
help us monitor influenza vaccine safety across the United States.
With support from the CDC, we have created an automated internet-based system that will follow-up
on any self-reported adverse symptoms to influenza vaccine after vaccination.
What is
this project
about?
Our project aims
to enhance
existing
monitoring of
vaccine safety
across the
United States.
We have created
an automated
web-based system
that will ask
you how you have
been feeling
after your
seasonal
vaccination over
the course of
several weeks.
What
will I have to
do?
If you agree to
participate at
www.myflushot.org,
you will be
asked to
complete an
online survey
that asks a
series of
questions
including
demographic
information,
influenza
vaccine history,
type of
influenza
vaccine
received, and
any medical
problems you may
have developed
since
vaccination.
The initial
survey will take
3 to 4 minutes
to complete,
with two short
follow-up online
surveys at 1
week and 6 weeks
after
vaccination.
Is there
any compensation
for me?
Unfortunately,
no.
However, your
responses will
help us in
ensuring that
this year’s
seasonal influenza
vaccines remain
safe and
effective.
How long
will this take?
The online
questionnaire
will only take 3
to 4 minutes.
Will I
receive unwanted
calls?
No. You
will only be
called if you
have given us
permission to
contact you.
Your personal
information will
not be disclosed
to anyone.
How do I get started?
Click the
button
below to
access the
survey.

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