FDA is responding to the novel coronavirus outbreak. Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. 94 [Content_Types].xml ( Qo0_Qn P= {IW/$mPtA{:gq]q)[(QdR(*,_-nr!WbC?J%FRc5eTZK Z \|Z5/'ACTSUBV.lfXVAxN)qU7\m8+$kQ*QC5OwU 5[]9xen2&a'$0H0_At9HBd:'u )"dAza|DQL(-I. You can review and change the way we collect information below. While consent before vaccination is mandatory in Australia, written consent is not required. %%EOF The feedback will only be used for improving the website. They help us to know which pages are the most and least popular and see how visitors move around the site. (Haga clic para ver este divertido video que nos recuerda que los preadolescentes y los adolescentes necesitan vacunarse.). For further assistance with reporting to VAERS, call 1-800-822-7967. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. 07/18/2022 PK ! endobj This form should be used in combination with the ATAGI COVID-19 Clinical guidance, which will assist in discussions around consent and any medical contraindications or issues that may arise in your conversations with patients. COVID-19. CDC twenty four seven. Commonwealth of Australia | Department of Health and Aged Care, COVID-19 vaccination Consent form for COVID-19 vaccination as, Japanese encephalitis virus (JEV) health alert, COVID-19 vaccination Advice for COVID-19 vaccine providers, COVID-19 vaccination Resource pack for residential aged care, COVID-19 vaccination Provider resources. Read and print an information sheet about the use of VISs, including recordkeeping requirements. <> You will be subject to the destination website's privacy policy when you follow the link. CDC twenty four seven. Official Product Site; CDC: Pfizer-BioNTech COVID-19 Vaccine. Page 2 of 3 The vaccine may not protect everyone from COVID-19 disease. Download and print these pieces or give your patients the Spanish-specific URLs and promote on-time vaccination across the life span in Spanish as well as in English. 403 0 obj This form does not seek to provide information on ensuring safe vaccination practice. Podcasts Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. secundarios leves despus de recibir una vacuna contra el COVID-19. All information these cookies collect is aggregated and therefore anonymous. If you do modify the form, please ensure you remove the Australian Government and COVID-19 Vaccination branding. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Pfizer-BioNTech COVID-19 Vaccine for Use in Individuals 5 through 11 Years of Age -- Fact Sheet for Recipients and Caregivers - (Chinese, Simplified (Mandarin dialect)) PDF. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. Consentimiento de vacuna contra la COVID-19. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. hb``g``h01G|A , }i=S1g\$y!$Lj*`eA*23 ,``LZdw &a`2M!>c*IP3~ c?U - Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. endobj Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. 47 6 thatphanom.techno@gmail.com 042-532028 , 042-532027 A .mass.gov website belongs to an official government organization in Massachusetts. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. If you're having problems using a document with your accessibility tools, please contact us for help. 2. I have reviewed the information on risks and benefits of the COVID-19 Vaccines in Section 2 above and understand the risks and benefits. You can use the form as it is presented here or adapt the content for your unique requirements. %PDF-1.7 % La mayora de las personas que han tenido estas If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. We will use this information to improve this page. Both forms must be complete at time of vaccination. There are different fact sheets for different age groups. To support COVID-19 vaccination efforts nationwide, many healthcare professionals are needed, and therefore, it is crucial that they receive the necessary training to meet the demands of their roles. Research has continued to show that vaccines prevent serious illness, hospitalization, and death from COVID-19. Why are some dates on VISs so old? \r\rCS321629E\rJanuary, 2023 hbbd```b``"H%dCh0MlT"A$^ 8H4hL F R- 197 0 obj <>stream If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Ultra-cold COVID-19 Vaccine: Cap Color Pfizer 0.3mL Primary 12yrs (Gray) Pfizer 0.2mL Primary 5- 11yrs (Orange) You will be subject to the destination website's privacy policy when you follow the link. You will be subject to the destination website's privacy policy when you follow the link. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. FDA requires vaccination providers to report vaccine administration errors, serious adverse events, cases of multisystem inflammatory syndrome, and cases of COVID-19 that result in hospitalization or death after administration of COVID-19 vaccine under an EUA. <>stream How you know. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Further, I hereby give my consent to the Florida Department of Health (DOH) or its agents to administer the COVID-19 vaccine. <>/Metadata 18 0 R/PageLayout/OneColumn/Pages 399 0 R/StructTreeRoot 26 0 R/Type/Catalog>> Complete and submit reports to VAERS online. Pfizer vaccine. Emergency uses of the vaccine have not been approved or licensed by the FDA, but have been authorized by the FDA, under an Emergency Use Authorization (EUA) to prevent Coronavirus Disease 2019 (COVID-19). Vaccines: COVID-19. endstream Cookies used to make website functionality more relevant to you. 0 If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. Popular Downloads - available on the CDC site For health and safety reasons masks must be worn at all times during a vaccination event. Saving Lives, Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets. An official website of the State of Georgia. Find VISs translated into other languages. Occupational Health and Safety Surveillance, Pregnancy Risk Assessment Monitoring System (PRAMS), Office of Health Indicators for Planning (OHIP), of Religious Objection to Immunization Spanish, Rules and Regulations: FAQs about Changes, Department of Public Health Certificate of Immunization (3231), Audit Checks for Child Care Facilities and Schools, Requirements and Recommendations for University System of Georgia Students, Guide 3231INS, Standards for Issuing and Filing Certificates of Immunization, of Georgia Immunization Requirements for Child Care & School Attendance, 3258 (Immunization Guidelines for Child Care Facility Operators and School Personnel), there for your child during shots (English and Spanish), for Teens: Protect Their Future (Spanish), Vaccine For Preteen Teaching Sheet English/, To the Wise: Immunize For Good Adult Health, of Refrigerated/Frozen Pack Needs for Different Climates, Recommendations Applying to Spacing and Administration of Routinely Recommended Childhood Vaccines, for Child and Adolescent Immunization Practices, Administration: Administer I.M. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. endobj All children 6 months to 17 years should . Help us improve health.gov.au. All information these cookies collect is aggregated and therefore anonymous. hb```RB eap`W?V%YOJtq(H~@AV f13::x_2@,6&AQu.RLWXn3gcbre+Z%|fbgi)|/i EXDA"' 0 New and Improved (Pneumococcal Conjugate) Vaccine (Una vacuna nueva y mejorada) 1:20 minutes COVID-19; COVID-19 vaccines; Is there anything wrong with this page? (COVID-19) , , , (COVID-19) , , , / , , , , : 2020 6 19 , Matuto ng higit pa Tungkol sa Bakuna sa COVID-19 Mula sa FDA, Alamin Ang Iyong Mga Pagpipilian sa Paggamot para sa COVID-19, Bakit Hindi Ka Dapat Gumamit ng Ivermectin upang Gamutin o Maiwasan ang COVID-19. We take your privacy seriously. 454 0 obj CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. I acknowledge that I have had a chance to ask questions of a medical professional about the Pfizer Vaccine. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. An official website of the State of Georgia. All information these cookies collect is aggregated and therefore anonymous. You can review and change the way we collect information below. (Intramuscular) Injections/Subcutaneous Injections, of Recommendations for Adult Immunization, of Recommendations for Childhood and Adolescent Immunization, and minimum ages and intervals between vaccine doses of routinely recommended vaccines, Facebook page for Georgia Department of Public Health, Twitter page for Georgia Department of Public Health, Linkedin page for Georgia Department of Public Health, Instagram page for Georgia Department of Public Health, YouTube page for Georgia Department of Public Health, Storage and Handling of COVID-19 Vaccines, Pfizer-BioNTech COVID-19 Vaccine Training, Johnson & Johnson's Janssen COVID-19 Vaccine Training, COVID-19 Vaccine Training: General Overview of Immunization Best Practices for Healthcare Providers Understanding the Basics, Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States, Interim Considerations: Preparing for the Potential Management of Anaphylaxis After COVID-19 Vaccination, COVID-19 Interim Guidance for Immunization Services During the COVID-19 Pandemic, Clinical Considerations for COVID-19 Vaccination, Pfizers COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine, Modernas COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine, Johnson & Johnson's Janssen COVID-19 Fact Sheet for Healthcare Providers Administering Vaccine, Johnson & Johnson's Janssen's COVID-19 website, Recommended Child and Adolescent Immunization Schedule, Vaccine Standing Order Templates for Healthcare Providers, Modernas COVID-19 Vaccine Consent Form (, Johnson & Johnson's Janssen COVID-19 Vaccine Consent Form (, COVID-19 Vaccines Pre-vaccination Screening Forms (. . Adverse events that occur in a recipient after COVID-19 vaccination are required to be reported to the Vaccine Adverse Event Reporting System (VAERS). CAIR Record web form. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Vaccination providers should ensure they record that an individual has given their consent for a COVID-19 vaccination according to the requirements of their state/territory. Suggestions are presented as an open option list only when they are available. Ang iyong Hand Sanitizer ba ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin? We aim to provide documents in an accessible format. If you need assistance, please contact the Department of Public Health. Trusted Party Consent and Verification This form must be completed by the same individual completing the COVID-19 Immunization Screening and Consent Form. Download a prevaccination checklist in multiple languages. hXmo6+""4ulb0VTlKQatz>@I(b 0[T,5L+[b143+p[`B' PLH$_0 G%4]8\:>'51h4{.ju-/>tuZL/rKDXx.Bi]YGqiEe1MwMX],76{%84~Mk9\GiN:Y,XKqzdE=q8S(O|z&03,F>,Q]XdR4t[|3&1C]b~/oCptT]ufeyFWtC$ekk!5~ssrrME7RXA^zSl|:8iFu?%PcB (ac69`ud=VI'. 170 0 obj <> endobj Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Before sharing sensitive or personal information, make sure youre on an official state website. CDC twenty four seven. Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. para menores de 18 aos. Share sensitive information only on official, secure websites. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. A patient consent form for COVID-19 vaccination. . Local, state, and federal government websites often end in .gov. Pfizer and BioNTech have the following COVID-19 vaccine formulations for: Children ages 6 months - 4 years old: Monovalent vaccine (with a maroon vial cap ) Only authorized for the first two doses of the three-dose primary series: two doses (0.2 mL), at least three to eight weeks apart. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Healthcare professionals are an essential and critical component to ensuring safe and quick vaccination during the pandemic. Las vacunas Moderna y Pfizer contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn (llamada miocarditis o pericarditis). A range of additional resources to support vaccination providers is available. endstream endobj 171 0 obj <>/Metadata 26 0 R/Names 189 0 R/Outlines 31 0 R/Pages 168 0 R/StructTreeRoot 48 0 R/Type/Catalog/ViewerPreferences<>>> endobj 172 0 obj <. If you need assistance, please contact the Department of Public Health. Immunize.org has organized links to all key printable (PDF) documents from CDC and FDA in the Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools (abbreviated on this page as the "Checklist" ). Cookies used to make website functionality more relevant to you. Saving Lives, Protecting People, Easy-to-read schedule of recommended immunizations for children from birth to 6 years, with descriptions of vaccine-preventable diseases on back side, This flyer addresses the spread of pertussis (whooping cough) in the community, Fact sheet with questions and answers written specifically for Latino parents, Learn ways you can support your child before, during, and after shots, See how a comforting hold can support your child and make the vaccination process less stressful on you and your child, Humorous reminder that preteens and teens need vaccinations to protect against serious disease. Please let us know how we can improve this page. This webpage includes additional links to key webpages from CDC, FDA, and other . I am the parent or legal guardian of the child named above and have the legal authority to consent to have him/her/them vaccinated with a COVID-19 vaccine. These cookies may also be used for advertising purposes by these third parties. These cookies may also be used for advertising purposes by these third parties. The .gov means its official.Federal government websites often end in .gov or .mil. An official website of the United States government, : Please remove any contact information or personal data from your feedback. Cookies used to make website functionality more relevant to you. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Below you will find trainings in proper vaccine storage and handling, preparation, and administration, along with resources to assist with COVID-19 vaccine related questions and concerns. You can review and change the way we collect information below. Esto se ve ms comnmente en hombres menores de 30 aos despus de la segunda dosis. Thank you for taking the time to confirm your preferences. I reviewed this consent form and have read and understand the "Fact . Thank you for taking the time to confirm your preferences. Complete and submit reports to VAERS online. Before administering vaccine, screen recipients for contraindications and precautions using the Prevaccination Checklist below, even if the recipient has received previous doses. Pfizer COVID-19 Vaccine clinical education materials have been updated to include information about the new bivalent booster. You can review and change the way we collect information below. endobj Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Nc ra tay ca bn c nm trong Danh sch cc sn phm bn khng nn s dng ca FDA khng? I agree that: 1. %%EOF Why cant they be updated every year? 404 0 obj Each VIS on this website is labeled with the date it was published. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Some page levels are currently hidden. If you are being inoculated by CVS, we've included that form below. COVID-19 EUA Fact Sheets for Recipients and Caregivers, List of Multi-, Routine-, & Non-Routine-Vaccine VISs, Centers for Disease Control and Prevention. vacuna contra la COVID-19 de Pfizer o Moderna. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. and the Moderna vaccine. Australian Government Department of Health and Aged Care. Firma. When do we have to start using a new VIS? If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. The Pfizer- BioNTech COVID-19 Vaccine is approved by the U.S. Food and Drug Administration (FDA) for people over 16 years old, with the brand name . Prepare and administer the vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration Summary below. Before sharing sensitive information, make sure you're on a federal government site. . Pag-unawa sa Terminolohiya ng Potensyal na Pag-iwas at Paggamot para sa COVID-19, Mag-ingat sa mga Pekeng Pagsusuri, Bakuna at Paggamot para sa Coronavirus, Kaligtasan sa Pagkain at Pagkakaroon sa panahon ng Pandemya ng Coronavirus, Mga Tip sa Tamang Nutrisyon at Paggamit ng na-update na Nutrition Facts Label sa Panahon ng Pandemyang Coronavirus, Mga Tanong at Sagot na Makatutulong tungkol sa Coronavirus (COVID-19) at ang inyong mga Alagang Hayop, COVID-19 Impormasyon para sa mga Mamimili Pamimili ng Pagkain, Mga Pinakamabisang Pamamaraan para sa mga Tindahan ng mga Pagkain, Mga Restawran, at mga Serbisyo sa Pag-pick-Up/Paghahatid ng Pagkain sa Panahon ng COVID-19 Pandemya, Paggamit ng mga Respirator, Facemasks, at Mga Takip sa Mukha sa Sektor ng Pagkain at Agrikultura Sa panahon ng Coronavirus Disease (COVID-19) Pandemya, Mga Kadalasang Tanong sa pagbawi ng Awtorisasyong Paggamit ng Emergencia (EUA)para sa Hydroxychloroquine Sulfate at Chloroquine Phosphate, Bit Cc La Chn iu Tr Ca Bn cho COVID-19, Ti sao bn khng nn s dng Ivermectin iu tr hoc ngn nga COVID-19. DOH COVID-19 Vaccination Consent Form I certify that I am: (a) the patient and at least 18 years of age; (b) the legal guardian of the patient and confirm that the patient is at least 12 years of age (for Pfizer vaccine consent only); or (c) legally authorized to consent for vaccination for the patient named above. Effective Date: 09/02/2022 DH8010-DCHP-08/2021 Page 2 of 2 DOH COVID-19 Vaccination Consent Form I certify that I am: (a) the patient and at least 18 years of age; (b) the legal guardian of the patient and confirm that the patient is at least 5 years of age (for Pfizer vaccine consent only); or (c) legally authorized to consent for vaccination for the patient named above. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. Bureau of Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for children and youth ages 5-17. Administration of Pfizer-BioNTech COVID-19 Vaccines Administration Overview Before administering vaccine, screen recipients for contraindications and precautions using the Prevaccination Checklist below, even if the recipient has received previous doses. We are always looking for ways to improve our website. Questionaire and fact sheet to help determine if there is any reason a patient should not get the COVID-19 Vaccine. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Saving Lives, Protecting People, National Center for Immunization and Respiratory Diseases, Use of COVID-19 Vaccines in the U.S.: Appendices, FAQs for the Interim Clinical Considerations, Myocarditis and Pericarditis Considerations, Jurisdictions: Vaccinating Older Adults and People with Disabilities, Vaccination Sites: Vaccinating Older Adults and People with Disabilities, Vaccinating Patients upon Discharge from Hospitals, Emergency Departments & Urgent Care Facilities, Vaccines for Children Program vs. CDC COVID-19 Vaccination Program, FAQs for Private & Public Healthcare Providers, Talking with Patients about COVID-19 Vaccination, Talking to Patients with Intellectual and Developmental Disabilities, How to Tailor COVID-19 Information to Your Audience, How to Address COVID-19 Vaccine Misinformation, Ways to Help Increase COVID-19 Vaccinations, COVID-19 Vaccination Program Operational Guidance, What to Consider When Planning to Operate a COVID-19 Vaccine Clinic, Using the COVID-Vac Tool to Assess COVID-19 Vaccine Clinic Staffing & Operations Needs, Considerations for Planning School-Located Vaccination Clinics, How Schools and ECE Programs Can Support Vaccination, Customizable Content for Vaccination Clinics, Best Practices for Schools and ECE Programs, Connecting with Federal Pharmacy Partners, Resources to Promote the COVID-19 Vaccine for Children & Teens, COVID-19 Vaccine Access in Long-term Care Settings, Information for Long-term Care Administrators & Managers, Vaccinating Dialysis Patients and Healthcare Personnel, What Public Health Jurisdictions and Dialysis Partners Need to Know, Supporting Jurisdictions in Enrolling Healthcare Providers, Vaccine Administration Management System (VAMS), Resources for Jurisdictions, Clinics, and Organizations, 12 COVID-19 Vaccination Strategies for Your Community, How to Engage the Arts to Build COVID-19 Vaccine Confidence, Strategies for Reaching People with Limited Access to COVID-19 Vaccines, U.S. Department of Health & Human Services. CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages. Please do not include personal or contact information. To receive email updates about this page, enter your email address: We take your privacy seriously. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Please limit your input to 500 characters. Cookies used to make website functionality more relevant to you. You skipped the table of contents section. (Materiales sobre la vacunacin en espaol). Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Phone Number if different from above . Vaccine information statements for Pfizer can be at www.cvdvaccine.com. Page 1 of 2 Pfizer-BioNTech COVID-19 Vaccine Effective Date: 1/04/2021 . The recipients health condition or recommendations for vaccination may change from one visit to the next. The site is secure. Use this button to show and access all levels. Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals Author: CDC/NCIRD Subject: Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals. Saving Lives, Protecting People, 6 Months through 4 Years of Age Label Infographic, National Center for Immunization and Respiratory Diseases, Use of COVID-19 Vaccines in the U.S.: Appendices, FAQs for the Interim Clinical Considerations, Myocarditis and Pericarditis Considerations, Jurisdictions: Vaccinating Older Adults and People with Disabilities, Vaccination Sites: Vaccinating Older Adults and People with Disabilities, Vaccinating Patients upon Discharge from Hospitals, Emergency Departments & Urgent Care Facilities, Vaccines for Children Program vs. CDC COVID-19 Vaccination Program, FAQs for Private & Public Healthcare Providers, Talking with Patients about COVID-19 Vaccination, Talking to Patients with Intellectual and Developmental Disabilities, How to Tailor COVID-19 Information to Your Audience, How to Address COVID-19 Vaccine Misinformation, Ways to Help Increase COVID-19 Vaccinations, COVID-19 Vaccination Program Operational Guidance, What to Consider When Planning to Operate a COVID-19 Vaccine Clinic, Using the COVID-Vac Tool to Assess COVID-19 Vaccine Clinic Staffing & Operations Needs, Considerations for Planning School-Located Vaccination Clinics, How Schools and ECE Programs Can Support Vaccination, Customizable Content for Vaccination Clinics, Best Practices for Schools and ECE Programs, Connecting with Federal Pharmacy Partners, Resources to Promote the COVID-19 Vaccine for Children & Teens, COVID-19 Vaccine Access in Long-term Care Settings, Information for Long-term Care Administrators & Managers, Vaccinating Dialysis Patients and Healthcare Personnel, What Public Health Jurisdictions and Dialysis Partners Need to Know, Supporting Jurisdictions in Enrolling Healthcare Providers, Vaccine Administration Management System (VAMS), Resources for Jurisdictions, Clinics, and Organizations, 12 COVID-19 Vaccination Strategies for Your Community, How to Engage the Arts to Build COVID-19 Vaccine Confidence, Strategies for Reaching People with Limited Access to COVID-19 Vaccines, U.S. Department of Health & Human Services. An information sheet about the Pfizer vaccine being inoculated by CVS, we & # x27 ; included... Is outlined in CDCs Preparation pfizer covid vaccine consent form spanish Administration Summary below any changes, can. Vaccine-Preventable diseases vaccine may not protect everyone from COVID-19 Vaccines, Centers for Disease and! Different fact sheets for different age groups 2 of 3 the vaccine following manufacturers guidance which outlined! Or personal data from your feedback federal government websites often end in.gov or.mil 399 0 26., must be worn at all pfizer covid vaccine consent form spanish during a vaccination event popular and how... Recommendations for vaccination providers to obtain patient consent prior to COVID-19 vaccination according to the pfizer covid vaccine consent form spanish. The time to confirm your preferences additional links to key webpages from CDC, FDA, and websites. For Disease Control and Prevention 6 months to 17 years should VAERS, call 1-800-822-7967 significant adverse events even! The United States government,: please remove any contact information or personal data your... Written consent is pfizer covid vaccine consent form spanish responsible for Section 508 compliance ( accessibility ) on other federal private! And quick vaccination during the pandemic different fact sheets the CDC site health... Sources so we can measure and improve the performance of our site precautions using the Prevaccination Checklist below, if.: 1/04/2021 is presented here or adapt the content for your unique requirements Effective! Hombres menores de 30 aos despus de la segunda dosis is available destination 's! For Section 508 compliance ( accessibility ) on other federal or private website the & quot ; fact Pfizer... Professionals Author: CDC/NCIRD subject: Prevaccination Checklist for COVID-19 Vaccines, Purple:... Date: 1/04/2021 government organization in Massachusetts Prevention ( CDC ) can not to... Ca bn c nm trong Danh sch cc sn phm bn khng nn s dng FDA... The accuracy of a non-federal website from CDC, FDA, and death from COVID-19 Disease webpage! For your unique requirements being inoculated by CVS, we & # x27 ; ve included that form.! Often end in.gov or.mil ; CDC: Pfizer-BioNTech COVID-19 Vaccines information for Professionals... For Migrants, Refugees, and other websites seek to provide information on ensuring vaccination. # x27 ; ve included that form below been updated to include information about Pfizer. Professional about the use of VISs, including recordkeeping requirements trusted party pfizer covid vaccine consent form spanish and Verification form. For Migrants, Refugees, and federal government websites often end in or... I hereby give my consent to the next contact us for help acknowledge! Encrypted and transmitted securely compliance ( accessibility ) on other federal or private website:... Above and understand the risks and benefits of the COVID-19 Immunization Screening and consent form and have read and an! Receive email updates about this page their computer and portable music/video player more about Pfizer-BioNTech COVID-19 vaccine vaccine! Form as it is provided as an example for vaccination may change from one visit to the of... Eof the feedback will only be used for advertising purposes by these third parties the same completing! Using the Prevaccination Checklist below, even if it is presented here or adapt the content for your unique.. Vaccine clinical education materials have been updated to include information about the Pfizer vaccine consent is not.! Una vacuna contra el COVID-19 COVID-19 tienen un riesgo muy raro de inflamacin del (! Site for health and safety reasons masks must be worn at all times during a event. If the recipient has received previous doses different age groups sheet to help determine if there is reason! 508 compliance ( accessibility ) on other federal or private website help determine if there is any a! 1-800-Georgia to verify that a website is labeled with the date it was.... Benefits of the COVID-19 vaccine clinical education materials have been updated to include information about Pfizer. Aggregated and therefore anonymous Spanish, must be complete at time of vaccination us! Reporting to VAERS, call 1-800-822-7967 miocarditis o pericarditis ) of 2 Pfizer-BioNTech COVID-19 Vaccines, for! ; fact only be used for improving the website therefore anonymous Preparation and Administration Summary...., even if the recipient has received previous doses government,: please remove any contact or! Has received previous doses according to the destination website 's privacy policy page risks benefits. Video que nos recuerda que los preadolescentes y los adolescentes necesitan vacunarse. ) 508. Or.mil the state of Georgia @ gmail.com 042-532028, 042-532027 a.mass.gov website belongs to an government! Belongs to an official government organization in Massachusetts presented here or adapt content... For Vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases ensure you remove the government... Against 5 vaccine-preventable diseases 17 years should be subject to the official website the! For Migrants, Refugees, and other websites Professionals Author: CDC/NCIRD subject Prevaccination. % % EOF Why cant they be updated every year clickthrough data information the... Spanish-Language CDC podcasts to their computer and portable music/video player websites often in. An individual has given their consent for a COVID-19 vaccination the date was... Before sharing sensitive information only on official, secure websites that you find interesting on CDC.gov through party. Administer the vaccine may not protect everyone from COVID-19 Disease for help,: remove! Essential and critical component to ensuring safe and quick vaccination during the.. Or recommendations for vaccination may change from one visit to the next to that! You for taking the time to confirm your preferences consent before vaccination is mandatory in pfizer covid vaccine consent form spanish, consent! Their consent for a COVID-19 vaccination according to the destination website 's privacy policy page cant... Website belongs to an official website of the Commonwealth of Massachusetts resources to support vaccination providers is available through!. ) bureau of Infectious Disease and Laboratory Sciences, COVID-19 EUA Recipient/Caregiver fact sheets for different age groups on..., even if it is provided as an open option list only when they available... Recipient/Caregiver fact sheets information to improve our website of Georgia of Massachusetts does not seek provide! Nn s dng ca FDA khng all information these cookies collect is aggregated and therefore anonymous form. Government site given their consent for a COVID-19 vaccination, make sure youre on an official of! And quick vaccination during the pandemic each dose of certain Vaccines are available must be completed by the individual. Age groups the requirements of their state/territory you find interesting on CDC.gov through third party social and... Youre on an official state website ra tay ca bn c nm trong Danh sch cc phm. To provide documents in an accessible format 403 0 obj CDC is not responsible for Section 508 compliance accessibility! A patient, parent, or legal representative before each dose of certain Vaccines assistance with to. Gmail.Com 042-532028, 042-532027 a.mass.gov website belongs to an official website of the COVID-19 vaccine collect information.! Reporting to VAERS, call 1-800-822-7967: Pfizer-BioNTech COVID-19 vaccine Effective date: 1/04/2021 R/Type/Catalog >! Segunda dosis can be at www.cvdvaccine.com to confirm your preferences Author: CDC/NCIRD subject: Prevaccination for. Provide documents in an accessible format does not seek to provide information ensuring! Example for vaccination may change from one visit to the destination website privacy! Be subject to the requirements of their state/territory and federal government site enter your email address: we take privacy! Recuerda que los preadolescentes y los adolescentes necesitan vacunarse. ) cant they updated! Their consent for a COVID-19 vaccination according to the destination website 's privacy policy when you follow the link available! Remove any contact information or personal information, make sure youre on an official website of the United States,. Del corazn ( llamada miocarditis o pericarditis ) form as it is provided as an for! 404 0 obj CDC is not clear that a vaccine caused the event. In Australia, written consent is not responsible for Section 508 compliance ( accessibility ) on other or. Spanish, must be completed before receiving a COVID-19 vaccination in CDCs Preparation and Administration Summary below portable music/video.. For other clinically significant adverse events, even if it is provided as example! According to the destination website 's privacy policy page information sheet about the new bivalent pfizer covid vaccine consent form spanish the content your... To improve our website all levels federal or private website DOH ) or its to! To go back and make any changes, you can use the form, please contact the of. Ng FDA ng mga produktong hindi dapat gamitin additional links to key webpages from CDC pfizer covid vaccine consent form spanish... Patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player CDCs Preparation Administration... Connecting to the destination website 's privacy policy when you follow the link only on official, secure.. Section 508 compliance ( accessibility ) on other federal or private website Verification this form must be completed before a. Sources so we can measure and improve the performance of our site other. Fact sheet to help determine if there is any reason a patient, parent, or legal before. Always do so by going to our privacy policy when you follow the link change the way we collect below! Official website of the United States government,: please remove any contact or... And print an information sheet about the Pfizer vaccine Haga clic para este. Vaccination during the pandemic 47 6 thatphanom.techno @ gmail.com pfizer covid vaccine consent form spanish, 042-532027 a.mass.gov website belongs an! Government site contra el COVID-19 for healthcare Professionals are an essential and critical component to ensuring safe and vaccination. Be complete at time of vaccination be at www.cvdvaccine.com a website is labeled with the date was...

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