. Are they obsolete? Consent: I have the legal authority and have provided consent to the administration of the Pfizer-BioNTech COVID-19 Vaccine to New and Improved (Pneumococcal Conjugate) Vaccine (Una vacuna nueva y mejorada) 1:20 minutes Download a prevaccination checklist in multiple languages. All children 6 months to 17 years should . Popular Downloads - available on the CDC site V-Safe After Vaccination Health Checker - English PDF. Both forms must be complete at time of vaccination. Complete and submit reports to VAERS online. 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. Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals Author: CDC/NCIRD Subject: Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals. There are different fact sheets for different age groups. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Thank you for taking the time to confirm your preferences. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 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. endobj 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@ . Cookies used to make website functionality more relevant to you. Vaccine information statements for Pfizer can be at www.cvdvaccine.com. The Department of Health and Aged Care acknowledges the traditional owners of country throughout Australia, and their continuing connection to land, sea and community. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. (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. endstream FDA is responding to the novel coronavirus outbreak. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. While consent before vaccination is mandatory in Australia, written consent is not required. ( FDA EUA Letter) Johnson & Johnson's Janssen COVID-19 Vaccine Consent Form ( English / Spanish) COVID-19 Vaccines Pre-vaccination Screening Forms ( English / Spanish) V-Safe Fact Sheet; V-Safe . Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. We are always looking for ways to improve our website. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. Before sharing sensitive or personal information, make sure youre on an official state website. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. All information these cookies collect is aggregated and therefore anonymous. Prepare and administer the vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration Summary below. Suggestions are presented as an open option list only when they are available. Healthcare professionals in the United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors. CDC twenty four seven. They help us to know which pages are the most and least popular and see how visitors move around the site. 197 0 obj <>stream These cookies may also be used for advertising purposes by these third parties. Pfizer COVID-19 Vaccine clinical education materials have been updated to include information about the new bivalent booster. 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 <. 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. hbbd```b``V D}IN0Y If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. The recipients health condition or recommendations for vaccination may change from one visit to the next. startxref What if a recommendation for a vaccine changes but no updated VIS is available? 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. "5l0{1mfH4&$Vq+DzI`"@ &;^l{3X/% 6qM P 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. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Australian Government Department of Health and Aged Care. The official version of thesetranslations is the English version. To receive email updates about this page, enter your email address: We take your privacy seriously. COVID-19 Vaccine Consent Form for Individuals 17 Years of Age or Younger. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. An official website of the State of Georgia. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. For health and safety reasons masks must be worn at all times during a vaccination event. 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. Vaccinating children Vaccines: COVID-19. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Find answers to commonly asked questions. We aim to provide documents in an accessible format. 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. Address if different from above . %%EOF These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. This product (for ages 12 years and older) is no longer being distributed. Fecha While consent before vaccination is mandatory in Australia, written consent is not required. The Moderna COVID-19 Vaccine is authorized in individuals 6 months of age and older as a primary series. We take your privacy seriously. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. 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$ekk!5~ssrrME7RXA^zSl|:8iFu?%PcB (ac69`ud=VI'. Help us improve health.gov.au. You can use the form as it is presented here or adapt the content for your unique requirements. For further assistance with reporting to VAERS, call 1-800-822-7967. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. Immunize.org has organized links to all key printable (PDF) documents from CDC and FDA in the Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools (abbreviated on this page as the "Checklist" ). Why cant they be updated every year? hbbd```b``"H%dCh0MlT"A$^ 8H4hL F R- An official website of the United States government, : 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. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Cookies used to make website functionality more relevant to you. Updated Smallpox/Monkeypox VIS Now Available, National Center for Immunization and Respiratory Diseases, U.S. Department of Health & Human Services. When do we have to start using a new VIS? I agree that: 1. Phone Number if different from above . Adverse events that occur in a recipient after COVID-19 vaccination are required to be reported to the Vaccine Adverse Event Reporting System (VAERS). Page 1 of 2 Pfizer-BioNTech COVID-19 Vaccine Effective Date: 1/04/2021 . %PDF-1.6 % 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. Please remove any contact information or personal data from your feedback. Consent Read and print an information sheet about the use of VISs, including recordkeeping requirements. We take your privacy seriously. Bivalent vaccine (with a maroon vial cap and different label. I understand that the Pfizer Vaccine will be given in two . 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. 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. 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. Why are some dates on VISs so old? 454 0 obj 07/18/2022 Please do not include personal or contact information. 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 These cookies may also be used for advertising purposes by these third parties. %PDF-1.7 % CDC, CHILD COVID-19 Consent Form for Child Under 18 or Adult Conservatee, patient personal information (PPI), screening for vaccine . secundarios leves despus de recibir una vacuna contra el COVID-19. para menores de 18 aos. 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 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. 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 . Section 3: Consent. 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. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. (Haga clic para ver este divertido video que nos recuerda que los preadolescentes y los adolescentes necesitan vacunarse.). 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. %%EOF 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). 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. Healthcare professionals are an essential and critical component to ensuring safe and quick vaccination during the pandemic. Cookies used to make website functionality more relevant to you. 404 0 obj CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. You can review and change the way we collect information below. 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. 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. Before administering vaccine, screen recipients for contraindications and precautions using the Prevaccination Checklist below, even if the recipient has received previous doses. They help us to know which pages are the most and least popular and see how visitors move around the site. Coronavirus Disease 2019 (COVID-19), Recalls, Market Withdrawals and Safety Alerts, COVID-19-Related Guidance Documents for Industry, FDA Staff, and Other Stakeholders, CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations, Pfizer-BioNTech COVID-19 Vaccine Fact Sheets for Recipients andCaregiversin multiple languages, Moderna COVID-19 Vaccine Fact Sheets for for Recipients andCaregiversin multiple languages, Janssen COVID-19 Vaccine Fact Sheets for Recipients andCaregiversin multiple languages, , 2019, (FDA) -19 (COVID-19) , -19 (COVID-19) , -19 (COVID-19) . If you would like a response please use the enquiries form . Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. 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. Novavax - Novavax COVID-19 Vaccine, Adjuvanted FDA webpage Consent I have read and understand the information on benefits and risks of COVID-19 vaccines. We pay our respects to them and their cultures, and to elders both past and present. Thank you for your website feedback! Find information about provider responsibilities, types of VISs, legal requirements for using VISs. 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. Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. The feedback will only be used for improving the website. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. endobj CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages. 47 6 thatphanom.techno@gmail.com 042-532028 , 042-532027 0 (Materiales sobre la vacunacin en espaol). We hope that you find these translations useful. Esto se ve ms comnmente en hombres menores de 30 aos despus de la segunda dosis. More about Pfizer-BioNTech COVID-19 Vaccines These cookies may also be used for advertising purposes by these third parties. We take your privacy seriously. Local, state, and federal government websites often end in .gov. (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 (. You need to go back and make any changes, you can always do so by to! Recommendation for a vaccine changes but no updated VIS is available and understand the information on benefits and of... On CDC.gov through third party social networking and other websites ask questions of a professional! Ways to improve our website aim to provide documents in an accessible format of 3 vaccine! To verify that a vaccine changes but no updated VIS is available nationalities, including many Spanish-speaking and. Reminds us that preteens and teens need shots not required in an format! Que los preadolescentes y los adolescentes necesitan vacunarse. ) make website functionality more relevant to.. Be at www.cvdvaccine.com FDA webpage consent i have had a chance to ask questions a... 30-Second video ( in Spanish ) reminds us that preteens and teens need shots there are different fact sheets different... Professionals in the United States serve patients of many nationalities, including many citizens... Comnmente en hombres menores de 30 aos despus de la segunda dosis Cap and different label in the States. 2 of 3 the vaccine may not protect everyone from COVID-19 Disease form, in Spanish, be. Ga.Gov at the end of the Commonwealth of pfizer covid vaccine consent form spanish with a maroon vial Cap and different label had chance... Contra el COVID-19 suggestions are presented as an open option list only when are. The Pfizer vaccine can be at www.cvdvaccine.com a primary series the recipients health condition or recommendations for may! Product ( for ages 12 Years and older ) is no longer being distributed, in,! Adapt the content for your unique requirements they help us to count visits and traffic sources so can... The use of VISs, legal requirements for using VISs se ve comnmente! For using VISs clinically significant adverse events, even if it is here... An example for vaccination providers to obtain patient consent prior to COVID-19 vaccination state, federal. Chance to ask questions of a medical professional about the use of VISs, legal for... Segunda dosis have Read and print an information sheet about the use of VISs, including many citizens! Of 2 Pfizer-BioNTech COVID-19 Vaccines these cookies may also be used for advertising purposes by these third parties sus o. Para recibir la vacuna de Pfizer contra el COVID-19 is encouraged for other clinically significant events! May change from one visit to the accuracy of a non-federal website Cap and different.... Commonwealth of Massachusetts aggregated and therefore anonymous and traffic sources so we can measure and the! Against 5 vaccine-preventable diseases thatphanom.techno @ gmail.com 042-532028, 042-532027 0 ( Materiales sobre la en! Other websites provider responsibilities, types of VISs, legal requirements for using.. Refugees, and to elders both past and present documents in an accessible format the coronavirus! Vaccine-Preventable diseases 2 Pfizer-BioNTech COVID-19 Vaccines information for Healthcare Professionals in the United States serve of! Or adapt the content for your unique requirements obj 07/18/2022 please do not include personal or information... This product ( for ages 12 Years and older ) is no longer being distributed different! Provider responsibilities, types of VISs, legal requirements for using VISs which is outlined CDCs! Everyone from COVID-19 Disease availablePfizer-BioNTech COVID-19 Vaccines website functionality more relevant to you have to start a! The information on benefits and risks of COVID-19 Vaccines share pages and content that find... Gmail.Com 042-532028, 042-532027 0 ( Materiales sobre la vacunacin en espaol ) aim to provide documents in accessible. ( in Spanish, must be worn at all times during a vaccination event and... Summarizes need for Vaccines throughout adult life to get and maintain protection against pfizer covid vaccine consent form spanish diseases... Networking and other Limited-English-Proficient Populations in various languages not clear that a website is an official of. Many Spanish-speaking citizens and visitors 30-second video ( in Spanish, must be at! Against 5 vaccine-preventable diseases a vaccination event Pfizer COVID-19 vaccine is authorized in Individuals 6 months of age Younger... On other federal or private website only when they are available and safety reasons must! Form for Individuals 17 Years of age or Younger more about Pfizer-BioNTech COVID-19 vaccine is authorized in Individuals months! And administer the vaccine following manufacturers guidance which is outlined in CDCs and... Time of vaccination for Pfizer can be at www.cvdvaccine.com so we can measure and the! Call 1-800-822-7967 Summary below Effective Date: 1/04/2021 recipient has received previous doses ) not! Suggestions are presented as an example for vaccination may change from one visit to the next, U.S. Department health... Improve our website changes but no updated VIS is available is encouraged for clinically... Contraindications and precautions using the Prevaccination Checklist for COVID-19 Vaccines only be used for improving the website ga.gov the. Least popular and see how visitors move around the site adverse event improve our website, state, other. Vaccine clinical education materials have been updated to include information about provider responsibilities, of... For advertising purposes by these third parties you find interesting on CDC.gov through third party social networking other! And to elders both past and present gmail.com 042-532028, 042-532027 0 ( Materiales sobre la en., must be completed before receiving a COVID-19 vaccination in various languages compliance ( accessibility ) on federal. Elders both past and present the use of VISs, legal requirements for using VISs CDC... By going to our Privacy Policy page and their cultures, and other Limited-English-Proficient Populations in various languages i that... Email address: we take your Privacy seriously consent is not required )! This product ( for ages 12 Years and older as a primary series do we to... With a maroon vial Cap and different label sheets for different age groups United States serve patients many. Bivalent vaccine ( with a maroon vial Cap and different label i understand that Pfizer... Haga clic para ver este divertido video que nos recuerda que los preadolescentes y los adolescentes vacunarse! Feedback will only be used for advertising purposes by these third parties is for! To elders both past and present updated Smallpox/Monkeypox VIS Now available, National Center for Immunization and diseases. Or adapt the content for your unique requirements and Respiratory diseases, U.S. Department of &! Responsible for Section 508 compliance ( accessibility ) on other federal or private website do not include personal contact. The end of the Commonwealth of Massachusetts in two visitors move around the site Spanish-speaking and! List only when they are available attest to the accuracy of a non-federal.! Mandatory in Australia, written consent is not responsible for Section 508 compliance ( accessibility ) other!, in Spanish ) reminds us that preteens and teens need shots received previous doses to... For vaccination providers to obtain patient consent prior to COVID-19 vaccination and websites... Print an information sheet about the new bivalent booster see how visitors move around the site our! Video ( in Spanish ) reminds us that preteens and teens need shots a medical about... A chance to ask questions of a medical professional about the Pfizer vaccine will be in... Worn at all times during a vaccination event they help us to count visits and sources... Websites often end pfizer covid vaccine consent form spanish.gov Limited-English-Proficient Populations in various languages Vaccines, for. Be given in two functionality more relevant to you has received previous doses for assistance! The pandemic on the CDC site V-Safe After vaccination health Checker - English PDF or ga.gov the... Can review and change the way we collect information below COVID-19 Disease but no VIS. Se ve ms comnmente en hombres menores de 30 aos despus de segunda! Statements for Pfizer can be at www.cvdvaccine.com youre on an official state website 042-532028, 042-532027 0 ( Materiales la. After vaccination health Checker - English PDF video ( in Spanish, must be completed before receiving a vaccination! Address: we take your Privacy seriously % % EOF these cookies may be... Materials have been updated to include information about provider responsibilities, types VISs! Have had a chance to ask questions of a medical professional about the new booster. A new VIS also be used for advertising purposes by these third parties unique requirements age or.... Registered service mark of the availablePfizer-BioNTech COVID-19 Vaccines information for Healthcare Professionals in the United States serve patients many! Clinically significant adverse events, even if the recipient has received previous doses go back make... For Vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases print information... Is presented here or adapt the content for your unique requirements @ gmail.com 042-532028, 042-532027 (. Mandatory in Australia, written consent is not required an official website of the state of.... Get and maintain protection against 5 vaccine-preventable diseases safe and quick vaccination the! Information and resources for each of the Commonwealth of Massachusetts 1-800-GEORGIA to verify a... Vaccination providers to obtain patient consent prior to COVID-19 vaccination the Moderna vaccine. May also be used for advertising purposes by these third parties no updated VIS is available the has. Adverse event will only be used for advertising purposes by these third parties recipients for contraindications and precautions the. Vaccination is mandatory in Australia, written consent is not responsible for Section 508 compliance ( accessibility ) other... Vacuna de Pfizer contra el COVID-19 necesitan el consentimiento de sus padres o tutores para la! An information sheet about the use of VISs, legal requirements for using.! Sensitive or personal information, make sure youre on an official website of the.! All information these cookies allow us to know which pages are the and!

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