Bivalent vaccine (with a maroon vial cap and different label. Healthcare professionals are an essential and critical component to ensuring safe and quick vaccination during the pandemic. 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) . Direccin si es diferente de la anterior. Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. 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 Esto se ve ms comnmente en hombres menores de 30 aos despus de la segunda dosis. All information these cookies collect is aggregated and therefore anonymous. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Firma. These cookies may also be used for advertising purposes by these third parties. 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. We take your privacy seriously. 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. FDA is responding to the novel coronavirus outbreak. (Check back as we will continue to. endobj Food and Drug Administration. If my child or adult conservatee does not have a . Healthcare professionals in the United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. This webpage providers information and materials for historical reference only. Nc ra tay ca bn c nm trong Danh sch cc sn phm bn khng nn s dng ca FDA khng? Thank you for your website feedback! Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. Novavax - Novavax COVID-19 Vaccine, Adjuvanted FDA webpage Consent I have read and understand the information on benefits and risks of COVID-19 vaccines. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. 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 ( How you know. Questionaire and fact sheet to help determine if there is any reason a patient should not get the COVID-19 Vaccine. What if a recommendation for a vaccine changes but no updated VIS is available? 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 you need to go back and make any changes, you can always do so by going to our Privacy Policy page. 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. 187 0 obj <>/Filter/FlateDecode/ID[<3C4CB76F7817EC43BD8A3A51D7CF58C8>]/Index[170 28]/Info 169 0 R/Length 90/Prev 97852/Root 171 0 R/Size 198/Type/XRef/W[1 3 1]>>stream PK ! 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. 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. Pfizer vaccine. If you're having problems using a document with your accessibility tools, please contact us for help. 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. Ang iyong Hand Sanitizer ba ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin? 197 0 obj <>stream Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. Before sharing sensitive information, make sure you're on a federal government site. secundarios leves despus de recibir una vacuna contra el COVID-19. New and Improved (Pneumococcal Conjugate) Vaccine (Una vacuna nueva y mejorada) 1:20 minutes Pre-Vaccination Screening Form: English Spanish; Pfizer. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 431 0 obj Share sensitive information only on official, secure websites. For health and safety reasons masks must be worn at all times during a vaccination event. We are always looking for ways to improve our website. "5l0{1mfH4&$Vq+DzI`"@ &;^l{3X/% 6qM P Administration of Pfizer-BioNTech COVID-19 Vaccines Administration Overview Before administering vaccine, screen recipients for contraindications and precautions using the Prevaccination Checklist below, even if the recipient has received previous doses. Cookies used to make website functionality more relevant to you. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. . 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 consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. Vaccine information statements for Pfizer can be at www.cvdvaccine.com. I reviewed this consent form and have read and understand the "Fact . 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. Find answers to commonly asked questions. All children 6 months to 17 years should . 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 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. They help us to know which pages are the most and least popular and see how visitors move around the site. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. Official Product Site; CDC: Pfizer-BioNTech COVID-19 Vaccine. You will be subject to the destination website's privacy policy when you follow the link. Cookies used to make website functionality more relevant to you. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Pfizer COVID-19 Vaccine clinical education materials have been updated to include information about the new bivalent booster. %PDF-1.6 % SECTION 3: INFORMATION ON THE RISKS AND BENEFITS OF COVID-19 VACCINES COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19. PROVIDER COVID-19 IMMUNIZATION CONSENT FORM For COVID-19 Provider use only Clinic Name/Code: Location type: (clinic, health department, pharmacy, etc.,) . These cookies may also be used for advertising purposes by these third parties. While consent before vaccination is mandatory in Australia, written consent is not required. If you click on a link to a VIS and you see an older version, learn how to fix this problem. We aim to provide documents in an accessible format. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. 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. 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. Mercy COVID-19 Vaccine Consent Form - Spanish Author: Hixson, Frances M Subject: covid-19 consent form Spanish Created Date: When do we have to start using a new VIS? If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. para menores de 18 aos. 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. 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. 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