How to apply to the Program?

Beware of Fraudulent “COVID-19 Compensation Lottery Prize” scam.

Make sure you are eligible to apply

You can submit an Application if you (or the person you represent) meet the following conditions:

  • be a resident or a citizen of any of the AMC Eligible Economies, or
  • be a person within the populations of concern to the COVAX Humanitarian Buffer, as defined and updated from time to time by the Inter-Agency Standing Committee (IASC), in an AMC Eligible Economy, and 
  • have been administered a Vaccine in an AMC Eligible Economy, and
  • have suffered a Serious Adverse Event which:
    • is associated with a Vaccine that has been received through the COVAX Facility in any of the AMC Eligible Economies, or with the administration of such a Vaccine (provided that such Vaccine has been earmarked for delivery through the COVAX Facility to any AMC Eligible Economy, or to a Humanitarian Agency for use in an AMC Eligible Economy, up to and inclusive of 30 June 2023, as tracked by the Administrator through such Vaccine’s batch or lot number), and 
    • has resulted in an Injury.

What is meant by an “Injury”?

The Program covers serious bodily injury or illness that is suffered or sustained by a Patient and that:

  • requires Hospitalization or prolongs an existing Hospitalization; 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.

Follow all steps in the Application process

STEP 1: OBSERVE THE 30-DAY WAITING PERIOD AFTER VACCINATION

You should wait 30 days after the administration of the COVAX-distributed COVID-19 Vaccine dose that is deemed to have resulted in the Injury, before (a) applying to the Program, and (b) obtaining any of the documents that are required to be submitted with your Application.

Exception: The 30-day waiting period does not apply if the Patient has died after a Vaccine dose was administered to him/her, and the Patient’s death is considered by a Registered Health Professional to have been caused by that Vaccine or its administration.

STEP 2: ENSURE THAT ALL APPLICATION MATERIALS ARE DULY COMPLETED, SIGNED AND DATED

After the 30-day waiting period described above is over, you can proceed to apply for compensation under the Program. To apply for compensation, you should:

  1. complete the Application Form; 
  2. ask relevant Registered Health Professional(s) to complete the Supporting Evidence Form; and
  3. obtain the other documents required to be submitted with these forms, such as:
    • invoices, receipts or other proof of payment for medical expenses (including Hospital fees, if any) incurred as a consequence of the Injury, 
    • if you are applying on behalf of a Patient, a power of attorney or notarized statement confirming that you are the legally authorized parent, guardian, heir or legal representative of that Patient,
    • the documents required to be submitted by the Registered Healthcare Professional(s) together with the Supporting Evidence Form,
    • any other document or information that supports your Application; and 
  4. submit all the documentation to the Administrator.

All Program forms and other resources (e.g. the Questions & Answers (FAQs) and the Application Checklist) can be found in Printable Program Forms and Other Documents.

You can complete the Application Form online if you wish, or you can download, print and complete the Application Form on paper. 

The Supporting Evidence Form and other Program Forms (except for the Application Form) cannot be completed online on the Program’s website; these forms can only be downloaded, printed, and completed on paper. 

The Application Form, the Supporting Evidence Form and all other Program forms must be completed and submitted in English, French or Spanish only; no other languages can be accepted by the Administrator. 

However, the other documents that are required to be provided with the Application Form and the Supporting Evidence Form (as described in these forms) can be obtained and submitted in other languages

Before moving to STEP 3, we strongly recommend that you go through the Application Checklist to make sure you are ready to submit your Application.

STEP 3: SUBMIT ALL YOUR DOCUMENTS

If you are eligible, and you have waited 30 days after the administration of the Vaccine, and you have all your documents duly completed, signed and dated, then you can apply to the Program by submitting your Application materials to the Program’s Administrator.  All Application materials should be submitted together and at the same time. 

Please note there is a fixed timeline by which all Application materials must be submitted to the Administrator. This fixed timeline is described as the “Reporting Period” in Section 2(t) of the Program’s Protocol and illustrated in Schedule 6 (Illustrative Diagram of the Reporting Period) to the Program’s Protocol. You can also find more information about the Reporting Period in our Questions & Answers.

Apply now

Apply if you have all documents ready.

Apply

Still need help?

If you still have questions or need assistance, you can either:

  • consult the Questions & Answers page for frequently asked questions and answers about the Program; or
  • read the Application Checklist; or
  • contact the Administrator by phone, email or regular mail. Please note that the Administrator cannot complete an Application or any other Program forms on your behalf.

Questions & Answers

Find all the answers to your questions.

Learn more

Application Checklist

To ensure your Application is complete, you can use the Application Checklist.

Download

Contact information

The Program’s Administrator and Regional Centers are available to help you.

Contact us