Get the free Meningococcal Meningitis and Hepatitis B Immunization Health History Form - etsu

This form is required for new students at postsecondary institutions in Tennessee to provide information about Hepatitis B and Meningococcal Meningitis and to document vaccination status.

How to fill out meningococcal meningitis and hepatitis

How to fill out Meningococcal Meningitis and Hepatitis B Immunization Health History Form

1. Obtain the Meningococcal Meningitis and Hepatitis B Immunization Health History Form from your healthcare provider or school.
2. Fill out the personal information section, including your name, date of birth, and contact information.
3. Provide information on any previous vaccinations you have received for Meningococcal Meningitis and Hepatitis B.
4. Indicate any medical conditions or allergies you may have that are relevant to these vaccinations.
5. Sign and date the form to certify that the information provided is accurate.
6. Submit the completed form to your healthcare provider or the designated office at your school.

Who needs Meningococcal Meningitis and Hepatitis B Immunization Health History Form?

1. Students who are entering college or university, as many institutions require proof of these vaccinations.
2. Individuals who are starting a new job in healthcare or another sector that requires vaccination.
3. People traveling to areas where these diseases are more prevalent and need to document their vaccination history.

People Also Ask about

Which vaccines are given against meningitis and hepatitis B?

Hib/MenC vaccine The meningitis C vaccine offers protection against a type of bacteria called meningococcal group C bacteria, which can cause meningitis. Babies are offered a combined Hib/MenC vaccine at 1 year of age.

Who was the famous person who had meningitis?

Influential English guitarist Jeff Beck, who rose to fame playing with the Yardbirds and later fronted the Jeff Beck Group, died on January 10 aged 78 after contracting bacterial meningitis. Bacterial meningitis happens when germs get into the tissues (the meninges) surrounding the brain and spinal cord.

Where did meningitis come from?

Meningococcemia is caused by bacteria called Neisseria meningitidis. The bacteria often live in a person's upper respiratory tract without causing signs of illness. They can be spread from person to person through respiratory droplets.

What is the history of meningococcal meningitis?

Meningococcal disease was never described in ancient times despite its distinctive rash in a substantial proportion of patients. In January 1805, Gaspard Vieusseux, a general practitioner, first clinically characterised meningococcal disease in a short epidemic at the Eaux Vives quarter in Geneva, Switzerland.

What is the history of meningococcal disease?

Meningococcal disease was never described in ancient times despite its distinctive rash in a substantial proportion of patients. In January 1805, Gaspard Vieusseux, a general practitioner, first clinically characterised meningococcal disease in a short epidemic at the Eaux Vives quarter in Geneva, Switzerland.

What is meningococcal B vaccine in English?

MenB vaccine. The MenB vaccine helps protect against meningococcal group B bacteria that can cause serious illnesses, including meningitis and sepsis. It's given to children when they're 8 weeks, 16 weeks and 1 year old.

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What is Meningococcal Meningitis and Hepatitis B Immunization Health History Form?

The Meningococcal Meningitis and Hepatitis B Immunization Health History Form is a document used to record an individual's immunization history specific to meningococcal meningitis and hepatitis B vaccines.

Who is required to file Meningococcal Meningitis and Hepatitis B Immunization Health History Form?

Typically, this form is required to be filed by students entering college, especially those residing in campus housing, as well as by individuals seeking employment in certain healthcare or educational settings.

How to fill out Meningococcal Meningitis and Hepatitis B Immunization Health History Form?

To fill out the form, individuals should provide personal information such as name, date of birth, and the dates of any previous vaccinations for meningococcal meningitis and hepatitis B, as well as a signature indicating consent.

What is the purpose of Meningococcal Meningitis and Hepatitis B Immunization Health History Form?

The purpose of the form is to ensure that individuals are appropriately immunized against meningococcal meningitis and hepatitis B, thereby minimizing the risk of outbreaks and ensuring public health safety.

What information must be reported on Meningococcal Meningitis and Hepatitis B Immunization Health History Form?

The form must report personal identification details, the dates of received vaccinations, any medical exemptions, and signatures from both the healthcare provider and the individual or guardian if applicable.