Skip to content
Eswatini Ministry of Health
Schedule Facilities
Schedule Communities
Schedule Business
Vaccination Certificate
Boosters
Contact Us
Menu
Close
Schedule Facilities
Schedule Communities
Schedule Business
Vaccination Certificate
Boosters
Contact Us
Eswatini Ministry of Health
Vaccine Registration - COVID-19
First Name
Last Name
National ID
Birthdate Month
Select...
January
February
March
April
May
June
July
August
September
October
November
December
Birthdate Day
Birthdate Year
Gender
Male
Female
Primary Phone
Secondary Phone
Inkhundla
Select...
Dvokodvweni
Gege
Gilgal
Hhukwini
Hosea
Khubuta
Kukhanyeni
Kumethula
Kwaluseni
Lamgabhi
Lobamba
Lobamba Lomdzala
Lomahasha
Lubuli
Ludzeludze
Lugongolweni
Madlangempisi
Mafutseni
Mahlangatja
Mangcongco
Manzini North
Manzini South
Maphalaleni
Maseyisini
Matsanjeni North
Matsanjeni South
Mayiwane
Mbabane East
Mbabane West
Mhlambanyatsi
Mhlangatane
Mhlume
Mkhiweni
Motshane
Mpolonjeni
Mtfongwaneni
Mtsambama
Ndzingeni
Ngudzeni
Ngwempisi
Nhlambeni
Nkhaba
Nkilongo
Nkomiyahlaba
Nkwene
Ntfonjeni
Ntondozi
Phondo
Piggs Peak
Sandleni
Shiselweni 1
Shiselweni 2
Sigwe
Siphocosini
Siphofaneni
Sithobela
Somntongo
Timphisini
Zombodze
Occupation Type
Select...
Agriculture and Forestry
Arts, Media, Communications
Business
Civil Service
Community Service
Construction and Engineering
Domestic Workers
Education
Electricity and Water
Energy and Oil
Fire Services
Finance
Healthcare
Hospitality and Food
Informal Traders
Information Technology
Legal Sector
Manufacturing
Mining
Marketing and Sales
Motoring Industry
NGO
Other Human Services
Police and Correctional Services
Professional Service Industry
Property and Real Estate
Religious Workers
Retail and Wholesale
Retirees
Science Industries
Students
Textile Industry
Tourism
Traditional Leaders
Transportation
Uniformed Services – Military
Unemployed
Where do you work?
Other workplace
Which of the following is closest to your position?
Select...
Active Case Finder/TB Screening Officer
Biomed/Maintenance Technician
Community Health Volunteer
Dietary
Health Data Clerk/Officer
Dentist/Hygienist
EMT/Paramedics
Environmental Health Officer
Epidemiology
Expert Clients
Health Accountant
Health Driver
Health Orderly/Cleaner/Labourer
Health Stores Officers
HMIS Staff
Hospital Administrator/Manager
HTS Counsellor
Laboratory/Phlebotomy
Medical Imaging
Medical Practitioner/Medical Doctor
Medical Technician
Mentor Mother
Nurse
Occupational Therapy
Pharmacy
Physiotherapy
Program Manager/Officer
Psychology/Psychosocial Support
Research
Rural Health Motivator
Secretary/Administration
Security
Speech and Language Therapy
What is the highest level of education completed?
Select...
Primary School
Secondary School
High school
Tertiary (College/University)
No Education
Place of Residence
Email (Receive Digital Vaccination Certificate)
Do you have any of the following comorbidities? Select all that apply
Asthma
Cancer
Diabetes
Heart Disease
High Blood Pressure
HIV
Kidney Disease
Nervous System Condition
Pregnancy
TB
Obesity
Other respiratory condition
Other
None of the above
Other comorbidities
Are you or could you be pregnant?
Yes
No
Are you breastfeeding
Yes
No
Are you planning to become pregnant in the next three months?
Yes
No
In the past two weeks, have you tested positive for COVID-19?
Yes
No
Have you ever had severe allergic / anaphylactic reaction to any vaccine?
Yes
No
Do you have a bleeding disorder or are you on a blood thinner?
Yes
No
Have you received a COVID-19 vaccine previously?
Yes
No
Have you had any vaccinations in the past 14 days?
Yes
No
Preferred SMS Language
English
Siswati
Partner assisted by
Select...
None
PACT
World Vision
Young Heroes
Swabcha
Other
Other
SEND
View Pfizer Minor Consent Form