COVID-19 Vaccination Registration
(Tech Demo Only)

Please note: As described near the button at the end of the form, this site is still under construction. It has not yet been adopted for scheduling by any vaccine distribution sites and may require re-entry of information at a later date. If re-entry of information is required, site developers intend to send a notification e-mail to at least anyone who signs up and promptly confirms an e-mail address, but appointment notifications will not be available until officials in the vaccine distribution chain choose to use this site or information exported from it.


Thank you for your interest in vaccination! Multiple Covid-19 vaccines have been demonstrated as providing safe and effective (though not 100% complete) protection against a painful and deadly illness which is now circulating in our communities. Getting vaccinated can help save your own life and the lives of other people around you.


As more vaccine is made, more people will be eligible to receive it. Whether or not you are part of a priority group eligible to receive the vaccine now, you can still register here to receive notice or a scheduled appointment when one that you are eligible for and which meets your criteria (for example, regarding location) becomes available. All else being equal, appointments scheduled by this site will be assigned in the order of registration completion (including e-mail address confirmation) on this site.


Anyone who wishes to be vaccinated is encouraged to pre-register on this page. This is one source of information that can help you find when vaccines are available. You are still welcome and encouraged to use other sources of information; this is a project intended to be helpful to many people but not guaranteed to be perfect. The operators of the website are not liable for shortcomings. If you have permission from another person to act as the only person allowed to sign them up for and manage their information on this site, you can manage a sign up for them on this site, from your own login.


Vaccine supplies are limited, so pre-registration does not mean immediate access to vaccination. Pre-registration offers you an opportunity to receive updates when vaccines become available at linked distribution centers. If you are pre-registered and awaiting a vaccine but find one that is not an appointment booked through this site, please come back and mark that in this system, so that any appointments available through this site can go to somebody who is actually searching.


Terms of Service: You may not interact with this site in an automated fashion, including automated form completion, screen-scraping, or use of "bots" in any form. You may not interact directly with any of its programming interfaces directly unless you (a) have been specifically authorized in writing to do so, (b) present an API key issued specifically to you, and (c) act within specified limits. Contact us if you are interested in API access (when developed, in the future). You may not sell appointments obtained through this site and may not sell services related to use of this site, including registration or appointment management services.


Privacy Policy: You are not required by any law to fill out this form or use this site. If you do choose to use it, most fields below are optional. Unless otherwise required by law, your information will only be used by the operators of this Web site for the purposes of sending you notifications or information pertaining to Covid-19 pandemic response and vaccination. Information entered here may also be shared with governmental officials and vaccine providers, for the primary purpose of being able to offer vaccine appointments. It may also be handled in accordance with their respective privacy polices. If you are offered or request an appointment at a vaccine distributor, or indicate you previously received a first dose of the vaccine there, your information will be shared with that distributor and may be handled in accordance with their respective privacy policies. Aggregated information entered on this site may also be made public in addition to being shared with officials in the vaccine distribution chain, for example to indicate how many people of a specified priority subgroup are awaiting appointments at particular locations. This privacy policy may be updated from time to time and will be posted or linked to from this page. Continued use of the site indicates consent to this privacy policy and the Terms above.


Basic Identification


Can bring a government-issued photo ID to the vaccination appointment:

Language preferences Only English is currently supported, but as other languages are added, e-mails and pages on this site automatically change according to preference.
This information may also be used for vaccine sites which prioritize minority language groups.
Languages are listed alphabetically.
Preferred Can use

Electronic Contact and Account Data
Either your or your account manager's e-mail address is required. Please enter an e-mail address here.


You are logged in and creating a new account, presumably for someone else.
If that is not your intention, click here to log out first.
If you leave the password fields blank but provide an e-mail address, they can use the Reset Password page to set their own password.
If you wish to change your own password, click here to do so.
Password cannot be blank. How about "" as a randomly-generated option?
The new password cannot be blank. The passwords do not match, and should.


Seeking vaccination?

Accept the following vaccine types:





Information used to determine priority group At most sites in the system, prioritization is based on the PA Department of Health's Vaccine Rollout plan, which currently allows any Pennsylvanian to be vaccinated if there is an approved vaccine, currently meaning anyone 16 years of age or older.
If you are visiting from another jurisdiction with tighter controls and want to see the previous prioritization plan as a tech demo, click here.
Though using the same group names, these groupings differ from the CDC recommendations which allow each state to make their own prioritization.
Specific vaccination sites may have more specific prioritization.
If you include your information accurately below, and keep it updated if it changes, this site should be able to match you with only the vaccination sites for which you would be eligible based on the information provided.
If you do not complete a field, the system will assume that you are in the lowest-priority group for that field.

Note: No vaccines are currently approved for persons under 16 years old.
Pre-registration here is still allowed, but no compatible appointment will be found until further studies of safety, efficacy, and dosing are completed and approval is granted by the FDA and other relevant public health authorities.
Some choices show explanatory examples when selected.
Examples of long-term care facilities: intermediate care facilities, personal care homes, assisted living facilities, community group homes, long-term structured residences, and residential treatment facilities for adults.
Examples of congregate care settings not specified as long-term care facilities include group homes and prisons (this definition also applies for place/field of work, below).




Residential Address (used to help find nearby sites and for prioritization at some sites)






miles:


Work Address (used to help find nearby sites and for prioritization at some sites)






miles:


Reachable vaccine distribution sites
Let me know if appointments are available at the following locations:
In the future, these will be shown on the map below, with the ability to click on markers for more information and to mark them as selected/deselected. However, at the time being, you can select from the list that will be populated after you click "Add distribution sites" under an address above.
Data below is from the state database of approved distribution centers.



Health insurance information Because of the strong public health benefits, this vaccine is being made available free of charge to nearly all who are eligible and able to receive it. While the vaccine itself is funded by the federal government, some sites require insurance information (if applicable) to be able to recuperate costs associated with vaccine administration. If a health insurance policy is in effect, please enter the information below and have the health insurance ID card available when arriving for the appointment.
Health insurance status:







Can bring health insurance ID card to the vaccination appointment:


This site can only be used by & for people who agree to the site's Terms of Service and Privacy Policy.
Errors were found in the form above. Please scroll up to see details.
Unfortunately, an error was encountered during pre-registration.
This error may not be your fault; the site is a relatively new site still under development.
If you keep getting errors, try to contact us with details.
Please note: This website is currently in active development, set up for testing purposes only. The database is completely wiped out fairly often, so any data you input at this time will likely not survive to actual deployment. If you are seeking a real sign-up, you can e-mail us to to help indicate support for the project and adoption from vaccine distributors and/or relevant officials. If you e-mail us the information requested on this page, we will fill out the form for you when this initial testing phase is over.

Thank you for your interest in COVID-19 vaccination to protect yourself, your family, and our community.