Form

Vaccine Damage Payment claim form

Use this form to claim Vaccine Damage Payment by post.

• From: Department for Work and Pensions
• Published: 1 April 2013
• Last updated: 31 December 2020 — See all updates

This publication was withdrawn on 1 November 2021

This claim form is no longer in use. It has been replaced by Vaccine Damage Payment Scheme: Claim for a vaccine damage payment.

Documents

[Withdrawn] Vaccine Damage Payment claim form

Ref: VAD1A

PDF, 361 KB, 17 pages

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Details

Check if you are eligible for a Vaccine Damage Payment.

Published 1 April 2013

Last updated 31 December 2020 + show all updates

1. 31 December 2020

   Added coronavirus (COVID-19) to the list of vaccinations on the claim form.

2. 29 April 2016

   Replaced forms with April 2016 versions.

3. 1 April 2013

   First published.