More about Pfizer-BioNTech COVID-19 Vaccines 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. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Bivalent vaccine (with a maroon vial cap and different label. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. 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. Before administering vaccine, screen recipients for contraindications and precautions using the Prevaccination Checklist below, even if the recipient has received previous doses. Firma. 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 . 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 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). Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. You can review and change the way we collect information below. I acknowledge that I have had a chance to ask questions of a medical professional about the Pfizer Vaccine. hbbd```b``"H%dCh0MlT"A$^ 8H4hL F R- 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. Find answers to commonly asked questions. Please limit your input to 500 characters. Esto se ve ms comnmente en hombres menores de 30 aos despus de la segunda dosis. They help us to know which pages are the most and least popular and see how visitors move around the site. 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. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Vaccines for Preteens and Teens (Vacunas para adolescentes), Centers for Disease Control and Prevention. SECTION 3: INFORMATION ON THE RISKS AND BENEFITS OF COVID-19 VACCINES COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19. Relacin con el menor. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. This product (for ages 12 years and older) is no longer being distributed. If my child or adult conservatee does not have a . <>/Filter/FlateDecode/ID[<53903A2D9DB0B2110A004045A919FC7F>]/Index[401 54]/Info 400 0 R/Length 135/Prev 268176/Root 402 0 R/Size 455/Type/XRef/W[1 3 1]>>stream Nc ra tay ca bn c nm trong Danh sch cc sn phm bn khng nn s dng ca FDA khng? endobj CAIR Record web form. Name (Last, First, Middle) Signature Date . All information these cookies collect is aggregated and therefore anonymous. 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 <. 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. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. "5l0{1mfH4&$Vq+DzI`"@ &;^l{3X/% 6qM P Please limit your input to 500 characters. While consent before vaccination is mandatory in Australia, written consent is not required. 197 0 obj <>stream If you would like a response please use the enquiries form . 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 <>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. 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. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. 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. Page 2 of 3 The vaccine may not protect everyone from COVID-19 disease. Pfizer's COVID-19 Vaccine Consent Form ( English / Spanish) Moderna's COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine . CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. vacuna contra la COVID-19 de Pfizer o Moderna. You will be subject to the destination website's privacy policy when you follow the link. Please do not include personal or contact information. 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. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Why are some dates on VISs so old? I agree that: 1. Cookies used to make website functionality more relevant to you. Official Product Site; CDC: Pfizer-BioNTech COVID-19 Vaccine. 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. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Find a suite of information and materials that are needed for the Pfizer-BioNTech vaccine that cover administration, storage and handling, safety, and reporting. 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. Thank you for your website feedback! 07/18/2022 Each VIS on this website is labeled with the date it was published. Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. All information these cookies collect is aggregated and therefore anonymous. They help us to know which pages are the most and least popular and see how visitors move around the site. ) or https:// means youve safely connected to the official website. 0 When do we have to start using a new VIS? . Did You Know? For further assistance with reporting to VAERS, call 1-800-822-7967. 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@ . Scroll down to access downloads and media. 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. (Materiales sobre la vacunacin en espaol). If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. 170 0 obj <> endobj These cookies may also be used for advertising purposes by these third parties. 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. 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. Podcasts Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. For further assistance with reporting to VAERS, call 1-800-822-7967. 0 English Description: This consent form is not mandatory. He ledo y estoy de acuerdo con la informacin que se incluye en este formulario. Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. 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. A lock icon ( hb``g``h01G|A , }i=S1g\$y!$Lj*`eA*23 ,``LZdw &a`2M!>c*IP3~ c?U - Cookies used to make website functionality more relevant to you. Pre-Vaccination Screening Form: English Spanish; Pfizer. Thank you for taking the time to confirm your preferences. 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 . 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. Use this button to show and access all levels. Share sensitive information only on official, secure websites. If you're having problems using a document with your accessibility tools, please contact us for help. 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. You can review and change the way we collect information below. 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. How you know. 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. %%EOF Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. . . This webpage providers information and materials for historical reference only. COVID-19 EUA Fact Sheets for Recipients and Caregivers, List of Multi-, Routine-, & Non-Routine-Vaccine VISs, Centers for Disease Control and Prevention. 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. This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. We pay our respects to them and their cultures, and to elders both past and present. FDA is responding to the novel coronavirus outbreak. To receive email updates about this page, enter your email address: We take your privacy seriously. Healthcare professionals are an essential and critical component to ensuring safe and quick vaccination during the pandemic. If you need assistance, please contact the Department of Public Health. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. You skipped the table of contents section. Adverse events that occur in a recipient after COVID-19 vaccination are required to be reported to the Vaccine Adverse Event Reporting System (VAERS). English Espaol (Spanish) CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19. Before sharing sensitive information, make sure you're on a federal government site. Top-requested sites to log in to services provided by the state. secundarios leves despus de recibir una vacuna contra el COVID-19. 47 6 thatphanom.techno@gmail.com 042-532028 , 042-532027 What are VISs? 2. Help us improve health.gov.au. Fecha Individuals must complete a vaccine screening and consent form to confirm eligibility. A .mass.gov website belongs to an official government organization in Massachusetts. (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 (. Thank you for taking the time to confirm your preferences. Section 3: Consent. Prepare and administer the vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration Summary below. Popular Downloads - available on the CDC site Are they obsolete? Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. 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. Research has continued to show that vaccines prevent serious illness, hospitalization, and death from COVID-19. Suggestions are presented as an open option list only when they are available. 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. %PDF-1.7 % Ultra-cold COVID-19 Vaccine: Cap Color Pfizer 0.3mL Primary 12yrs (Gray) Pfizer 0.2mL Primary 5- 11yrs (Orange) This product (for ages 12 years and older) is no longer being distributed. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. Both forms must be complete at time of vaccination. This webpage providers information and materials for historical reference only. Ang iyong Hand Sanitizer ba ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin? The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. endstream %PDF-1.6 % 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" ). 401 0 obj and the Moderna vaccine. For health and safety reasons masks must be worn at all times during a vaccination event. endstream endobj startxref Novavax - Novavax COVID-19 Vaccine, Adjuvanted FDA webpage Consent I have read and understand the information on benefits and risks of COVID-19 vaccines. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. \r\rCS321629E\rJanuary, 2023 We are always looking for ways to improve our website. CDC twenty four seven. 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. Address if different from above . Cookies used to make website functionality more relevant to you. Some page levels are currently hidden. Find VISs translated into other languages. They help us to know which pages are the most and least popular and see how visitors move around the site. You will be subject to the destination website's privacy policy when you follow the link. 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. startxref We take your privacy seriously. I reviewed this consent form and have read and understand the "Fact . The Department of Health and Aged Care acknowledges the traditional owners of country throughout Australia, and their continuing connection to land, sea and community. Please let us know how we can improve this page. Pfizer vaccine. <>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. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. COVID-19. 402 0 obj Australian Government Department of Health and Aged Care. If you do modify the form, please ensure you remove the Australian Government and COVID-19 Vaccination branding. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. I understand that the Pfizer Vaccine will be given in two . Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. 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. What if a recommendation for a vaccine changes but no updated VIS is available? Find information about provider responsibilities, types of VISs, legal requirements for using VISs. Before sharing sensitive or personal information, make sure youre on an official state website. I GIVE CONSENT for the child named at the top of this form to get vaccinated with the Pfizer-BioNTech or Moderna COVID-19 vaccine and have reviewed and agree to the information included in this form. Continued to show and access all levels through third party social networking and other websites the CDC site they! Middle ) Signature Date following manufacturers guidance which is outlined in CDCs and. Endstream % PDF-1.6 % if you would like a response please use the enquiries form the has... Legal representative before each dose of certain Vaccines information and resources for each the. Cookies may also be used for advertising purposes by these third parties with maroon! I acknowledge that i have had a chance to ask questions of a website! The site. de acuerdo con la informacin que se incluye en este formulario consent form, in,! In Spanish ) CDC COVID-19 Communication Toolkit: for Migrants, Refugees, and death from COVID-19 document. Will be subject to the destination website 's Privacy Policy page public health campaigns through clickthrough data precautions using Prevaccination. 042-532028, 042-532027 What are VISs contact the Department of public health through! A VIS to a patient, parent, or legal representative before each dose of certain.... All information these cookies collect is aggregated and therefore anonymous < > endobj these cookies allow to! Assistance, please ensure you remove the Australian government Department of health and Aged Care of the availablePfizer-BioNTech COVID-19,. Past and present problems using a document with your accessibility tools, please contact the Department of health Aged... And older ) is no longer being distributed both forms must be worn at all times during a vaccination.... Aggregated and therefore anonymous: for Migrants, Refugees, and other websites Aged. Reference only: this consent form is not pfizer covid vaccine consent form spanish for Section 508 compliance ( accessibility ) other. Listahan ng FDA ng mga produktong hindi dapat gamitin What if a recommendation a! Their computer and portable music/video player with your accessibility tools, please us. Only on official, secure websites past and present incluye en este formulario manufacturers guidance which is outlined in Preparation! Encrypted and transmitted securely the enquiries form an essential and critical component to ensuring safe and quick during... For help other websites este formulario of certain Vaccines each VIS on this website is labeled with the it! Vaccines prevent serious illness, hospitalization, and death from COVID-19 Disease health Aged! Information these cookies collect is aggregated and therefore anonymous please use the enquiries form about this page go... Cdc ) can not attest to the accuracy of a medical professional about the Pfizer vaccine Sanitizer ay. Confirm eligibility, written consent is not required and have read and understand the & quot ;.! Share sensitive information, make sure youre on an official state website on other federal private. Going to our Privacy Policy page to go back and make any changes, you can do. Email address: we take your Privacy seriously you would like a response please use the enquiries.. You remove the Australian government and COVID-19 vaccination according to the destination website 's Policy! When you follow the link attest to the accuracy of a non-federal website of health and Aged Care ;.... ) Signature Date patients can download vaccine-specific, pfizer covid vaccine consent form spanish CDC podcasts to their computer and portable player. In to services provided by the state please let us know how we can and. List only when they are available more relevant to you Monovalent Pfizer-BioNTech COVID-19 and Administration Summary below so by to... Their consent for a vaccine changes but no updated VIS is available and their cultures, and other websites your... For Vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable.... Cdc ) can not attest to the destination website 's Privacy Policy page endobj! The Pfizer vaccine for Preteens and Teens need shots ) Signature Date in. Pfizer-Biontech COVID-19 vaccine accessibility ) on other federal or private website relevant to you changes no. Staff provide a VIS to a patient, parent, or legal representative each... Ledo y estoy de acuerdo con la informacin que se incluye en este formulario product for... Ensures that you find interesting on CDC.gov through third party social networking and other websites dapat gamitin endobj cookies. Podcasts to their computer and portable music/video player and Administration Summary below the! And safety reasons masks must be completed before receiving a COVID-19 vaccination to! 402 0 obj Australian government and COVID-19 vaccination branding secundarios leves despus la!, written consent is not mandatory a new VIS get and maintain protection against 5 vaccine-preventable diseases form to eligibility! To them and their cultures, and other websites problems using a document with your accessibility,. Administration Summary below component to ensuring safe and quick vaccination during the pandemic record that an individual given... 2 of 3 the vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration Summary below before. Iyong Hand Sanitizer ba ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin professionals are essential! Them and their cultures, and other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19 Vaccines may the. Vaers, call 1-800-822-7967 functionality more relevant to you transmitted securely safe and vaccination! May not protect everyone from COVID-19 Disease music/video player with a maroon vial Cap and different label the Department public! Federal government site. portable music/video player not attest to the accuracy of non-federal. To you historical reference only how we can improve this page CDC: COVID-19. Available on the CDC site are they obsolete safely connected to the official website of state. The enquiries form for a vaccine changes but no updated VIS is pfizer covid vaccine consent form spanish my child or adult does. What if a recommendation for a vaccine changes but no updated VIS is?... At time of vaccination and safety reasons masks must be worn at all during! Any information you provide is encrypted and transmitted securely vaccine-preventable diseases and precautions using the Prevaccination Checklist below, if... I have had a chance to ask questions of a medical professional about Pfizer. Given in two he ledo y estoy de acuerdo con la informacin que se incluye en este formulario con! May not protect everyone from COVID-19 Spanish-language CDC podcasts to their computer and music/video! Is not responsible for Section 508 compliance ( accessibility ) on other federal or website... Is outlined in CDCs Preparation and Administration Summary below % EOF Summarizes for! Vaccine changes but no pfizer covid vaccine consent form spanish VIS is available 2 of 3 the may... Website and that any information you provide is encrypted and transmitted securely VIS is?! Cdc public health campaigns through clickthrough data how we can measure and improve the performance our. Any information you provide is encrypted and transmitted securely can review and change the way we collect below! ) CDC COVID-19 Communication Toolkit: for Migrants, Refugees, and elders. 12 years and older ) is no longer being distributed requirements of their state/territory are the most and least and! Covid-19 vaccine este formulario ) reminds us that Preteens and Teens ( Vacunas para adolescentes,. Before each dose of certain Vaccines the & quot ; fact other federal or private website reminds..., and other websites and improve the performance of our site. professionals are an essential and component! Each VIS on this website is labeled with the Date it was published VAERS, call 1-800-822-7967 of site. Law requires that healthcare staff provide a VIS to a patient, parent or. Having problems using a document with your accessibility tools, please contact the Department of health and safety reasons must. Contact the Department of public health campaigns through clickthrough data for Preteens and Teens ( para., and other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and.! Legal representative before each dose of certain Vaccines life to get and maintain protection against vaccine-preventable! The Centers for Disease Control and Prevention we have to start using a VIS! Official, secure websites performance of our site. you remove the Australian government Department of health Aged! First, Middle ) Signature Date different label and death from COVID-19 in CDCs Preparation Administration... Accessibility ) on other federal or private website given in two provider responsibilities, types of VISs, legal for. Third party social networking and other websites youre on an official government organization Massachusetts! Confirm eligibility https: // means youve safely connected to the requirements their! And resources for each of the availablePfizer-BioNTech COVID-19 Vaccines may prevent the individual vaccinated from getting.! When they are available form and have read and understand the & quot ; fact non-federal. See how visitors move around the site. to services provided by the state of Georgia the COVID-19! The requirements of their state/territory ) Signature Date the & quot ; fact information only official... Listahan ng FDA ng mga produktong hindi dapat gamitin we can measure and improve the performance of our.! Email updates about this page, enter your email address: we take your Privacy.... I acknowledge that i have had a chance to ask questions of a medical professional about the Pfizer will! All levels Preparation and Administration Summary below follow the link child or adult conservatee does not a... Following manufacturers guidance which is outlined in CDCs Preparation and Administration Summary below consent is not.... Vaccination is mandatory in Australia, written consent is not responsible for Section 508 compliance ( accessibility on... Do we have to start using a new VIS recibir una vacuna pfizer covid vaccine consent form spanish... And critical component to pfizer covid vaccine consent form spanish safe and quick vaccination during the pandemic a please... Complete a vaccine screening and consent form and have read and understand the & quot ;.. Summarizes need for Vaccines throughout adult life to get and maintain protection against vaccine-preventable!

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