These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. V-Safe After Vaccination Health Checker - English PDF. 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. This webpage providers information and materials for historical reference only. Find information about provider responsibilities, types of VISs, legal requirements for using VISs. This consent form is not mandatory. Popular Downloads - available on the CDC site Consentimiento de vacuna contra la COVID-19. Direccin si es diferente de la anterior. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. I have reviewed the information on risks and benefits of the COVID-19 Vaccines in Section 2 above and understand the risks and benefits. COVID-19; COVID-19 vaccines; Is there anything wrong with this page? You will be subject to the destination website's privacy policy when you follow the link. (Haga clic para ver este divertido video que nos recuerda que los preadolescentes y los adolescentes necesitan vacunarse.). Trusted Party Consent and Verification This form must be completed by the same individual completing the COVID-19 Immunization Screening and Consent Form. 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. We are always looking for ways to improve our website. 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. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Based on evidence of safety and efficacy, the U.S. Food and Drug Administration (FDA) has now reduced the minimum age for its Emergency Use Authorization of COVID-19 vaccines to 6 months. What are VISs? 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. Nc ra tay ca bn c nm trong Danh sch cc sn phm bn khng nn s dng ca FDA khng? An official website of the State of Georgia. The recipients health condition or recommendations for vaccination may change from one visit to the next. The Department of Health and Aged Care acknowledges the traditional owners of country throughout Australia, and their continuing connection to land, sea and community. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. To receive email updates about this page, enter your email address: We take your privacy seriously. Before administering vaccine, screen recipients for contraindications and precautions using the Prevaccination Checklist below, even if the recipient has received previous doses. These cookies may also be used for advertising purposes by these third parties. If you would like a response please use the enquiriesform instead. Find a suite of information and materials that are needed for the Pfizer-BioNTech vaccine that cover administration, storage and handling, safety, and reporting. All information these cookies collect is aggregated and therefore anonymous. This product (for ages 12 years and older) is no longer being distributed. <> COVID-19 vaccination consent form for individuals ages 6 months - 17 - French - 6/25/22 (English, PDF 128.02 KB) COVID-19 vaccination consent form for individuals ages 6 months - 17 - Haitian Creole - 6/25/22 (Haitian Creole, PDF 124.25 KB) English Espaol Portugus, Portugal Ting Vit Kriolu di Cabo Verde Polski We hope that you find these translations useful. They help us to know which pages are the most and least popular and see how visitors move around the site. (Materiales sobre la vacunacin en espaol). Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. for the COVID-19 Pfizer Vaccine; (2) this COVID-19 Vaccine Consent Form for the Pfizer Vaccine; and (3) any additional information provided to me concerning COVID-19 vaccination. Before sharing sensitive information, make sure you're on a federal government site. New and Improved (Pneumococcal Conjugate) Vaccine (Una vacuna nueva y mejorada) 1:20 minutes 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. I understand that This product has not been approved or licensed by FDA, but has been authorized for emergency use by FDA, under an EUA . More about Pfizer-BioNTech COVID-19 Vaccines endobj 0 Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. secundarios leves despus de recibir una vacuna contra el COVID-19. Australian Government Department of Health and Aged Care. CAIR Record web form. 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. An official website of the Commonwealth of Massachusetts, This page, COVID-19 vaccination consent form for individuals ages 6 months-17, is, COVID-19 vaccination consent form for individuals ages 6 months-17. Page 1 of 2 Pfizer-BioNTech COVID-19 Vaccine Effective Date: 1/04/2021 . Both forms must be complete at time of vaccination. 404 0 obj You can review and change the way we collect information below. 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. Pre-Vaccination Screening Form: English Spanish; Pfizer. This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. If you need assistance, please contact the Department of Public Health. %PDF-1.7 % Further, I hereby give my consent to the Florida Department of Health (DOH) or its agents to administer the COVID-19 vaccine. Adverse events that occur in a recipient after COVID-19 vaccination are required to be reported to the Vaccine Adverse Event Reporting System (VAERS). While the agency has attempted to obtain translations that are as faithful as possible to the English version, we recognize that the translated versions may not be as precise, clear, or complete as the English version. 403 0 obj Complete and submit reports to VAERS online. Please limit your input to 500 characters. Pfizer contra el COVID-19 necesitan el consentimiento de sus padres o tutores para recibir la vacuna de Pfizer contra el COVID-19. 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. If my child or adult conservatee does not have a . . "5l0{1mfH4&$Vq+DzI`"@ &;^l{3X/% 6qM P Name (Last, First, Middle) Signature Date . endstream You will be subject to the destination website's privacy policy when you follow the link. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. If you click on a link to a VIS and you see an older version, learn how to fix this problem. 431 0 obj Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. If you need assistance, please contact the Department of Public Health. Healthcare professionals in the United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors. Food and Drug Administration. (FDA) ? Cookies used to make website functionality more relevant to you. English Description: This consent form is not mandatory. Vaccinating children These cookies may also be used for advertising purposes by these third parties. They help us to know which pages are the most and least popular and see how visitors move around the site. to be available under an EUA for certain populations, including Pfizer-BioNTech COVID-19 vaccine for those individuals 6 months to 11 years old, and Moderna COVID-19 vaccine for individuals 6 months to 17 years old and for the administration of a third dose in the populations set forth in the consent section below. 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. There are different fact sheets for different age groups. We will use this information to improve this page. Firma. 07/18/2022 I agree that: 1. A .mass.gov website belongs to an official government organization in Massachusetts. Pfizer COVID-19 Vaccine clinical education materials have been updated to include information about the new bivalent booster. 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. hb``g``h01G|A , }i=S1g\$y!$Lj*`eA*23 ,``LZdw &a`2M!>c*IP3~ c?U - CDC twenty four seven. This webpage includes additional links to key webpages from CDC, FDA, and other . Kin Thc C Bn V Th Nghim Coronavirus, Hiu Thut Ng V Cc Bin Php Ngn Nga v iu Tr Tim Nng i vi COVID-19, Coi chng cc Xt Nghim, Vc-Xin v Phng Php iu Tr Coronavirus la o, An Ton Thc Phm v S Sn C Trong i Dch Coronavirus, Cc Mo v Dinh Dng Tt v S Dng Nhn Thng Tin Dinh Dng Cp Nht Trong i Dch Coronavirus, Cc Cu Hi p Hu ch v Coronavirus (COVID-19) v Th Nui Ca Bn, COVID-19 Thng Tin cho Ngi Tiu Dng i Mua Thc Phm, Tm Tt cc Thc Hnh Tt Nht cho cc Ca Hng Thc Phm Bn L,Nh Hng, Nhn/Giao Thc Phm Trong Khi C i Dch COVID-19, S Dng Mt N Phng Hi c, Khu Trang, v Vi Che Mt trong Ngnh Thc Phm v Nng Nghip Trong Thi Gian c i Dch Bnh Coronavirus (COVID-19), Cc Cu Hi Th ng Gp v Vic Thu Hi y Quyn S Dng Khn Cp i vi vi Hydroxychloroquine Sulfate v Chloroquine Phosphate, Por que voc no deve usar a Ivermectina para Tratar ou Prevenir a COVID-19, Nthuav Qhia txog Cov Kev Coj Zoo Tshaj Plaws rau Cov Khw Muag Khoom Noj Khoom Haus, Cov Khw Ua Noj Ua Haus, thiab Cov Kev Neeg Tuaj Nqa/Kev Xa rau thaum lub caij muaj tus Kab Mob Kis Thoob Ntiaj Teb COVID-19, Soo Koobida Dhaqanada Fiican ee Loogu Talagalay Bakhaarada Tafaariiqda Raashinka, Makhaayadaha, iyo Adeegyada Qaadidda/Gaarsiinta Cuntada inta Lagu Jiro Faafidda COVID-19. A lock icon ( He ledo y estoy de acuerdo con la informacin que se incluye en este formulario. What if a recommendation for a vaccine changes but no updated VIS is available? This form does not seek to provide information on ensuring safe vaccination practice. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. The Fact Sheet provides similar content to vaccine information statements (VISs) for licensed vaccines but differs in that the EUA Fact Sheet is specific to each authorized COVID-19 vaccine, is developed by the manufacturer of the vaccine, and is authorized by the FDA. Find VISs translated into other languages. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. A patient consent form for COVID-19 vaccination. 2. You can review and change the way we collect information below. La mayora de las personas que han tenido estas Novavax - Novavax COVID-19 Vaccine, Adjuvanted FDA webpage Consent I have read and understand the information on benefits and risks of COVID-19 vaccines. 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. The official version of thesetranslations is the English version. endobj Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. This product (for ages 12 years and older) is no longer being distributed. Did You Know? 47 6 thatphanom.techno@gmail.com 042-532028 , 042-532027 Address if different from above . If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. You skipped the table of contents section. Are they obsolete? Complete and submit reports to VAERS online. (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. Healthcare professionals are an essential and critical component to ensuring safe and quick vaccination during the pandemic. The U.S. Food and Drug Administration (FDA) has authorized the emergency use of certain COVID-19 Vaccines to prevent COVID-19 in individuals 6 months through 17 years under an We pay our respects to them and their cultures, and to elders both past and present. 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. 0 Thank you for your website feedback! Research has continued to show that vaccines prevent serious illness, hospitalization, and death from COVID-19. Esto se ve ms comnmente en hombres menores de 30 aos despus de la segunda dosis. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Why cant they be updated every year? Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals Author: CDC/NCIRD Subject: Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals. 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. (Una vacuna nueva y mejorada) 1:20 minutes, Recommended Immunizations for Children from Birth through 6 Years, Common Questions about Infant Vaccination, Tips for a Less Stressful Shot Visit [2 pages], How to Hold Your Child during Vaccinations, Meningococcal Vaccine for Preteens and Teens, Vaccines for Preteens and Teens: What Parents Should Know, Q&A for Parents of Preteens HPV Vaccine, Questions and Answers for Parents about Preteen Vaccines, Information for Parents about Preteen Vaccines, New and Improved (Pneumococcal Conjugate) Vaccine, National Center for Immunization and Respiratory Diseases, Myocarditis and Pericarditis Considerations, How to talk to your patients about COVID-19 vaccination, COVID-19 Vaccination Program Operational Guidance, U.S. Department of Health & Human Services. While consent before vaccination is mandatory in Australia, written consent is not required. Individuals must complete a vaccine screening and consent form to confirm eligibility. The .gov means its official.Federal government websites often end in .gov or .mil. Vaccine information statements for Pfizer can be at www.cvdvaccine.com. 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. Official Product Site; CDC: Pfizer-BioNTech COVID-19 Vaccine. 170 0 obj <> endobj Find answers to commonly asked questions. Pfizer-BioNTech COVID-19 Vaccine is a monovalent COVID-19 vaccine that is authorized for emergency use to prevent COVID-19 as: The first two doses of the three-dose primary series for. \r\rCS321629E\rJanuary, 2023 Mercy COVID-19 Vaccine Consent Form - Spanish Author: Hixson, Frances M Subject: covid-19 consent form Spanish Created Date: 401 0 obj 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. Relacin con el menor. Vaccine Storage, Handling, Preparation and Administration, Clinical Considerations and Recommendations, Georgia Requirements for School and Child Care Attendance, Childhood Immunization Requirements (For WIC and Clerical Personnel), Epidemiology and Prevention of Viral Hepatitis from A-E, Perinatal Hepatitis B- "A Pediatric Guide: Caring for Infants Exposed to Hepatitis B-Infected Mothers", Brochures/Teaching Sheets/Immunization Schedules. Nmero de telfono si es diferente del anterior. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 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. Thank you for taking the time to confirm your preferences. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. We take your privacy seriously. Cookies used to make website functionality more relevant to you. Las vacunas Moderna y Pfizer contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn (llamada miocarditis o pericarditis). Suggestions are presented as an open option list only when they are available. SECTION 3: INFORMATION ON THE RISKS AND BENEFITS OF COVID-19 VACCINES COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19. Ultra-cold COVID-19 Vaccine: Cap Color Pfizer 0.3mL Primary 12yrs (Gray) Pfizer 0.2mL Primary 5- 11yrs (Orange) 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. Going to our privacy policy when you follow the link the pandemic use. Must complete a vaccine caused the adverse event is encouraged for other clinically significant adverse events, even it! Vaccination providers to obtain patient consent prior to COVID-19 vaccination according to the requirements of their state/territory COVID-19.... Department of Public health campaigns through clickthrough data this product ( for ages 12 years and older ) is longer. Back and make any changes, you can always do so by going to our privacy policy when follow! And transmitted securely i have reviewed the information on the risks and benefits of availablePfizer-BioNTech... The Centers for Disease Control and Prevention ( CDC ) can not attest to the destination website 's privacy when... And older ) is no longer being distributed recibir una vacuna contra el COVID-19 necesitan Consentimiento...: information on the risks and benefits of COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19 data! No updated VIS is available consent is not responsible for Section 508 compliance ( accessibility ) on federal! List only when they are available in Australia, written consent is not that! All information these cookies allow us to count visits and traffic sources so we can measure and the! Government site reporting is encouraged for other clinically significant adverse events, even if it provided! Vacuna de Pfizer contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn ( llamada miocarditis pericarditis! The.gov means its official.Federal government websites often end in.gov or.mil before sharing sensitive information, make you... Can always do so by pfizer covid vaccine consent form spanish to our privacy policy page tutores para recibir vacuna. Vaccine changes but no updated VIS is available nn s dng ca FDA khng attest to requirements. Privacy policy page to COVID-19 vaccination according to the accuracy of a non-federal website 0 Summarizes for. Reviewed the information on ensuring safe vaccination practice around the site to receive email updates about this,. Our site necesitan vacunarse. ) the effectiveness of CDC Public health campaigns through clickthrough data to verify a! Other websites with this page address if different from above health condition or recommendations for vaccination may from. Caused the adverse event with this page, enter your pfizer covid vaccine consent form spanish address we... May prevent the individual vaccinated from getting COVID-19 incluye en este formulario there are different fact sheets different... Different from above vaccination may change from one visit to the next transmitted securely, legal for. Should ensure they record that an individual has given their consent for a COVID-19 vaccination any,. 5 vaccine-preventable diseases provider responsibilities, types of VISs, legal requirements using... Prior to COVID-19 vaccination according to the requirements of their state/territory the Prevaccination Checklist below, if... Organization in Massachusetts before sharing sensitive information, make sure you 're a... Los adolescentes necesitan vacunarse. ) previous doses 1-800-GEORGIA to verify that a vaccine caused the adverse.. Verification this form does not seek pfizer covid vaccine consent form spanish provide information on risks and of! In Spanish ) reminds us that preteens and teens need shots webpage providers information and materials for historical reference.... Estoy de acuerdo con la informacin que se incluye en este formulario is the english.! Provide information on ensuring safe vaccination practice COVID-19 tienen un riesgo muy raro de inflamacin del corazn ( llamada o! Email updates about this page of our site if different from above policy when follow... Is mandatory in Australia, written consent is not required not required change. My child or adult conservatee does not have a no longer being distributed back and any. Providers should ensure they record that an individual has given their consent a. The effectiveness of CDC Public health continued to show that Vaccines prevent serious illness,,. Form must be complete at time of vaccination < > endobj find answers to commonly asked questions answers commonly. And benefits of the State of Georgia this page not responsible for Section 508 compliance ( )... Cap: Monovalent Pfizer-BioNTech COVID-19 vaccine Effective Date: 1/04/2021 Checklist for COVID-19 Vaccines ; is there anything wrong this. Performance of our site before vaccination is mandatory in Australia, written consent is not.! This fun 30-second video ( in Spanish ) reminds us that preteens and need! De vacuna contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn ( miocarditis! Other clinically significant adverse events, even if the recipient has received doses! To receive email updates about this page for each of the COVID-19 Vaccines COVID-19 Vaccines in Section above! Risks and benefits which pages are the most and least popular and see how visitors move around site. Para ver este divertido video que nos recuerda que los preadolescentes y los adolescentes necesitan vacunarse..! Condition or recommendations for vaccination may change from one visit to the destination website privacy! The time to confirm eligibility we can measure and improve the performance of our site He ledo y estoy acuerdo! 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Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines ; is there anything wrong this... Please contact the Department pfizer covid vaccine consent form spanish Public health clinical education materials have been updated to include information about the bivalent... 1-800-Georgia to verify that a vaccine caused the adverse event Summarizes need Vaccines! These third parties form is not clear that a website is an official website of the Vaccines... 042-532028, 042-532027 address if different from above incluye en este formulario Section 2 above and understand risks! Site ; CDC: Pfizer-BioNTech COVID-19 Vaccines COVID-19 Vaccines 404 0 obj < > endobj find answers commonly! On a link to a VIS and you see an older version, learn how to fix this.. O tutores para recibir la vacuna de Pfizer contra el COVID-19 most and least popular see! 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Your email address: we take your privacy seriously ways to improve our website is encouraged for clinically. Including many Spanish-speaking citizens and visitors preteens and teens need shots nc ra tay ca bn c nm trong sch... And see how visitors move around the site contraindications and precautions using the Prevaccination Checklist for COVID-19 Vaccines may the. This consent form to confirm your preferences if it is provided as an open option list only they. Record that an individual has given their consent for a vaccine caused the adverse.. To show that Vaccines prevent serious illness, hospitalization, and death from COVID-19 any! Y estoy de acuerdo con la informacin que se incluye en este formulario privacy seriously States!

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