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With any experimental vaccine, it is important to monitor its effects on public health.


We are asking every individual who takes the vaccine, or who knows someone who has taken it, to report on its effects, especially if those effects are bad. 

You don't have to be a doctor, or medically trained. Simply observe any increase in illness following the vaccine. 

  • Increases in inflammation, swellings, pain, temperature

  • Increases in infections

  • Loss of mobility

  • Difficulties with breathing

Your information will be valuable in helping the wider community know whether the vaccine is safe or not. Your information may save lives. You may be contacted for further information about your symptoms. Your contribution may help prevent suffering and save lives.

This form was created by Craig Paardekooper, a pharmaceutical sciences student at Kingston University. He is a member of NHS Staff for Choice - a group of 2400 doctors, nurses and research staff who believe that vaccination should be by consent, and there should be no restrictions imposed on those who refuse it.

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