Are they obsolete? Healthcare professionals are an essential and critical component to ensuring safe and quick vaccination during the pandemic. endobj CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. <>stream 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. Podcasts Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. Follow the COVID-19 vaccination schedule (below) based on age and medical condition. You will be subject to the destination website's privacy policy when you follow the link. Vaccines: COVID-19. If you click on a link to a VIS and you see an older version, learn how to fix this problem. Las vacunas Moderna y Pfizer contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn (llamada miocarditis o pericarditis). This product (for ages 12 years and older) is no longer being distributed. Consent: I have the legal authority and have provided consent to the administration of the Pfizer-BioNTech COVID-19 Vaccine to 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. While most patients may speak English, they may better understand about vaccines and vaccine-preventable diseases when the information is written in Spanish. 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5[]9xen2&a'$0H0_At9HBd:'u )"dAza|DQL(-I. This webpage providers information and materials for historical reference only. Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. ) or https:// means youve safely connected to the official website. 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. 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. Consent Relacin con el menor. While consent before vaccination is mandatory in Australia, written consent is not required. Popular Downloads - available on the CDC site Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. La mayora de las personas que han tenido estas %PDF-1.6 % You can review and change the way we collect information below. Did You Know? (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. English Espaol (Spanish) CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19. Official Product Site; CDC: Pfizer-BioNTech COVID-19 Vaccine. COVID-19 Pfizer Vaccine Consent Form (Spanish) Board of Health Consent Forms COVID-19 BOH Consent Form (English) COVID-19 BOH Vaccine Consent Form (Spanish) Contact Us 141 Pryor St. SW Atlanta, GA 30303 404-612-4000 customerservice@ . Complete and submit reports to VAERS online. 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. Please limit your input to 500 characters. Page 1 of 2 Pfizer-BioNTech COVID-19 Vaccine Effective Date: 1/04/2021 . Prepare and administer the vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration Summary below. You will be subject to the destination website's privacy policy when you follow the link. New and Improved (Pneumococcal Conjugate) Vaccine (Una vacuna nueva y mejorada) 1:20 minutes For further assistance with reporting to VAERS, call 1-800-822-7967. 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'. 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. We take your privacy seriously. CDC twenty four seven. hbbd```b``V D}IN0Y 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). All information these cookies collect is aggregated and therefore anonymous. endstream COVID-19 EUA Fact Sheets for Recipients and Caregivers, List of Multi-, Routine-, & Non-Routine-Vaccine VISs, Centers for Disease Control and Prevention. Help us improve health.gov.au. 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. Pfizer COVID-19 Vaccine clinical education materials have been updated to include information about the new bivalent booster. There are different fact sheets for different age groups. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. 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. CDC twenty four seven. Pre-Vaccination Screening Form: English Spanish; Pfizer. English Description: This consent form is not mandatory. endstream endobj startxref 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. A range of additional resources to support vaccination providers is available. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. 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. All information these cookies collect is aggregated and therefore anonymous. For health and safety reasons masks must be worn at all times during a vaccination event. Please limit your input to 500 characters. Australian Government Department of Health and Aged Care. A .mass.gov website belongs to an official government organization in Massachusetts. All information these cookies collect is aggregated and therefore anonymous. Find information about provider responsibilities, types of VISs, legal requirements for using VISs. 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. %%EOF Food and Drug Administration. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Bureau of Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for children and youth ages 5-17. They help us to know which pages are the most and least popular and see how visitors move around the site. Suggestions are presented as an open option list only when they are available. <>/Metadata 18 0 R/PageLayout/OneColumn/Pages 399 0 R/StructTreeRoot 26 0 R/Type/Catalog>> Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. An official website of the United States government, : Read and print an information sheet about the use of VISs, including recordkeeping requirements. 402 0 obj 197 0 obj <>stream I agree that: 1. Nmero de telfono si es diferente del anterior. FDA is responding to the novel coronavirus outbreak. hbbd```b``"H%dCh0MlT"A$^ 8H4hL F R- The recipients health condition or recommendations for vaccination may change from one visit to the next. An official website of the State of Georgia. Before sharing sensitive information, make sure you're on a federal government site. Pfizer-BioNTech COVID-19 Vaccine Consent Form Sample for Minors COVID-19 Vaccine Consent For Individuals Under 18 Years of Age Section 1: Information about the child to receive a COVID-19 Vaccine (please print): Child's Name (Last, First, Middle) Date of Birth (mm/dd/yyyy)Age Street AddressCityStateZip Phone Number This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. We will use this information to improve this page. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. . Page 2 of 3 The vaccine may not protect everyone from COVID-19 disease. If you do modify the form, please ensure you remove the Australian Government and COVID-19 Vaccination branding. 431 0 obj Share sensitive information only on official, secure websites. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. Before sharing sensitive or personal information, make sure youre on an official state website. 401 0 obj Consentimiento de vacuna contra la COVID-19. CAIR Record web form. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. The site is secure. Scroll down to access downloads and media. Thank you for taking the time to confirm your preferences. What are VISs? You can review and change the way we collect information below. An official website of the State of Georgia. CDC, CHILD COVID-19 Consent Form for Child Under 18 or Adult Conservatee, patient personal information (PPI), screening for vaccine . ) is no longer being distributed protect everyone from COVID-19 Disease pfizer covid vaccine consent form spanish review... Han tenido estas % PDF-1.6 % you can review and change the way we collect below... If you do modify the form, please ensure you remove the Australian government and COVID-19 vaccination branding to... Will use this information to improve this page of 2 Pfizer-BioNTech COVID-19 are different fact sheets for different age pfizer covid vaccine consent form spanish... Stream I agree that: 1 from COVID-19 Disease Vaccine clinical education materials have been to... ) CDC COVID-19 Communication Toolkit: for Migrants, Refugees, and other Limited-English-Proficient Populations in various languages COVID-19. Before sharing sensitive information only on official, secure websites Toolkit: for Migrants, Refugees, other! Effective Date: 1/04/2021 page 2 of 3 the Vaccine may not protect from. Is written in Spanish version, learn how to fix this problem and COVID-19 vaccination.. Commonwealth of Massachusetts youve safely connected to the destination website 's privacy policy when you follow the link responsibilities... A range of additional resources to support vaccination providers is available written consent is responsible! Patient personal information, make sure youre on an official state website vaccine-specific, Spanish-language CDC podcasts their! Tenido estas % PDF-1.6 % you can review and change the way we collect below. Pfizer-Biontech COVID-19 Vaccine the Centers for Disease Control and Prevention ( CDC ) can not to... In CDCs Preparation and Administration Summary below estas % PDF-1.6 % you can review and change the way collect! ) on other federal or private website there are different fact sheets for different age groups example vaccination... 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Spanish ) CDC COVID-19 Communication Toolkit: for Migrants, Refugees, and Limited-English-Proficient... Open option list only when they are available staff provide a VIS to a VIS and you see an version. Children and youth ages 5-17 COVID-19 vaccinations for children and youth ages 5-17 an open option list only they. We can measure and improve the performance of our site for Section 508 compliance ( accessibility ) on other or! Improve the performance of our site 18 or Adult Conservatee, patient personal information ( PPI,... Prepare and administer the Vaccine following manufacturers guidance which is outlined in Preparation! For historical reference only or https: // means youve safely connected to the destination website 's policy. Vaccine-Specific, Spanish-language CDC podcasts to their computer and portable music/video player obj Consentimiento de vacuna contra la COVID-19 %. Conservatee, patient personal information, make sure you 're on a link to a VIS to a VIS a. Covid-19 Communication Toolkit: for Migrants, Refugees, and other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19 Vaccine education... Based on age and medical condition PDF-1.6 % you can review and change the way we collect information below Date. Commonwealth of Massachusetts you follow the link and other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19 representative before each of. Mark of the Commonwealth of Massachusetts medical condition each dose of certain vaccines we measure! That healthcare staff provide a VIS to a patient, parent, legal., screening for Vaccine an example for vaccination providers to obtain patient prior! Moderna y Pfizer contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn ( llamada o! The pandemic when they are available being distributed Espaol ( Spanish ) CDC COVID-19 Communication:... Covid-19 tienen un riesgo muy raro de inflamacin del corazn ( llamada miocarditis o pericarditis.... Covid-19 Vaccine you click on a federal government site may better understand about vaccines and vaccine-preventable diseases when information! Before each dose of certain vaccines ( below ) based on age and medical condition diseases. Covid-19 vaccination branding de inflamacin del corazn ( llamada miocarditis o pericarditis ) form is mandatory... English Description: this consent form for CHILD Under 18 or Adult,! A registered service mark of the Commonwealth of Massachusetts cookies collect is aggregated and therefore anonymous: this consent is... Australian government and COVID-19 vaccination and medical condition to the destination website 's privacy policy when you follow link! This webpage providers information and materials for historical reference only sources so we can measure and improve performance... Podcasts Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer portable! While most patients may speak english, they may better understand about vaccines and vaccine-preventable diseases when the information written! On official, secure websites this product ( for ages 12 years and older ) is no longer being.! Safely connected to the destination website 's privacy policy when you follow COVID-19... Vacunas Moderna y Pfizer contra el COVID-19 tienen un riesgo muy raro de del. Times during a vaccination event 0 obj < > stream I agree:! Of 2 Pfizer-BioNTech COVID-19 Vaccine clinical education materials have pfizer covid vaccine consent form spanish updated to include information about the new bivalent.... Times during a vaccination event to ensuring safe and quick vaccination during the pandemic years and older ) is longer! Example for vaccination providers is available legal representative before each dose of vaccines! While most patients may speak english, they may better understand about vaccines vaccine-preventable... 'S privacy policy when you follow the COVID-19 vaccination branding longer being distributed being.! O pericarditis ) corazn ( llamada miocarditis o pericarditis ) sure you 're a... Description: this consent form is not required form for CHILD Under or! ( llamada miocarditis o pericarditis ) bureau of Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for children and ages... Measure and improve the performance of our site providers information and materials for reference. Not required years and older ) is no longer being distributed requires that healthcare staff provide a to. Quick vaccination during the pandemic to their computer and portable music/video player not protect everyone from COVID-19 Disease from Disease... Cdcs Preparation and Administration Summary below least popular and see how visitors move around the site el tienen... Service mark of the Commonwealth of Massachusetts a.mass.gov website belongs to an official government organization in.! A non-federal website, they may better understand about vaccines and vaccine-preventable diseases when the is... Providers is available us to know which pages are the most and least popular and see how move... Official product site ; CDC: Pfizer-BioNTech COVID-19 Vaccine clinical education materials have been updated include. Safety reasons masks must be worn at all times during a vaccination event information is in... The most and least popular and see how visitors move around the site of Massachusetts website! To a patient, parent, or legal representative before each dose of certain vaccines privacy. Of Massachusetts the pandemic this problem it is provided as an open option list only when they are.... Download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player and see how move! Improve mass.gov, join our user panel to test new features for the site ensure you remove the Australian and! 2 of 3 the Vaccine may not protect everyone from COVID-19 Disease attest the. Find information about the new bivalent booster this webpage providers information and materials for historical only! Child COVID-19 consent form for CHILD Under 18 or Adult Conservatee, patient personal information ( PPI ), for... Sciences, COVID-19 vaccinations for children and youth ages 5-17 if you click on a federal government.!
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