Get the free Meningococcal Meningitis Vaccination Response Form - slc

This form is required for college and university students in New York State to document their immunization status against meningococcal meningitis as per public health law.

How to fill out meningococcal meningitis vaccination response

How to fill out Meningococcal Meningitis Vaccination Response Form

1. Gather necessary personal information including your name, date of birth, and contact details.
2. Locate the section for vaccination details and enter the date you received the Meningococcal Meningitis vaccine.
3. Provide information about the healthcare provider or facility where the vaccination was administered.
4. If applicable, indicate whether you have received any booster doses and include the dates.
5. Complete any additional sections regarding health history or allergies as prompted by the form.
6. Review all entered information for accuracy before submitting the form.

Who needs Meningococcal Meningitis Vaccination Response Form?

1. Individuals traveling to certain countries where Meningococcal disease is common.
2. College students, especially those living in dormitories.
3. Military recruits.
4. Certain healthcare workers or individuals in close contact with confirmed cases.
5. People with specific medical conditions that increase their risk for Meningococcal disease.

People Also Ask about

Can you have a reaction to the meningitis vaccine?

Be sure to notify your doctor of any side effects that occur after your child receives this vaccine. Fainting may occur after receiving intramuscular injections, such as this vaccine. It may occur with other symptoms including: blurred vision, numbness or tingling in your arms, hands, or feet, or seizures.

What are the reactions to meningococcal vaccine?

Among the participants who received NmCV-5 at age 15 months relative to participants who received MenACWY-TT, the difference in the prevalence of seroprotection was 0.8% (95% CI, –0.6% to 3.7%) for serogroup A, –0.8% (95% CI, –3.3% to 2.5%) for serogroup C, 0.3% (95% CI, –1.8% to 3.5%) for serogroup W, and 1.4% (95% CI

What are the side effects of the meningococcal vaccine?

Soreness, redness or swelling where the shot was given. Muscle pain. Headache.

What is the most common adverse reaction following either type of meningococcal vaccine?

If you have a reaction to the meningococcal shot, it will most likely be mild. Side effects may include: Mild pain and redness at the injection site. Slight fever.

Is it normal to feel sick after a meningococcal vaccine?

Meningococcal B vaccine side effects Soreness, redness, or swelling where the shot is given, tiredness, fatigue, headache, muscle or joint pain, fever, chills, nausea, or diarrhea can happen after meningococcal B vaccination. Some of these reactions occur in more than half of the people who receive the vaccine.

What is the meningitis response form?

Provide information about a student's past immunization for meningitis, or confirm that the student will not be immunized.

What are the results of meningitis vaccine?

The meningococcal conjugate vaccine (MenACWY) protects against four types of meningococcal bacteria (types A, C, W, and Y). It is recommended for all kids and teens age 11 and older.

For pdfFiller’s FAQs

What is Meningococcal Meningitis Vaccination Response Form?

The Meningococcal Meningitis Vaccination Response Form is a document used to report the vaccination status of individuals against meningococcal disease.

Who is required to file Meningococcal Meningitis Vaccination Response Form?

Individuals such as college students, particularly freshmen, and certain healthcare workers are typically required to file the Meningococcal Meningitis Vaccination Response Form.

How to fill out Meningococcal Meningitis Vaccination Response Form?

To fill out the form, individuals need to provide personal information, vaccination details, and the date of vaccination, adhering to the guidelines provided.

What is the purpose of Meningococcal Meningitis Vaccination Response Form?

The purpose of the form is to ensure that individuals are vaccinated against meningococcal disease and to maintain records for public health safety.

What information must be reported on Meningococcal Meningitis Vaccination Response Form?

The form must report the individual's name, date of birth, vaccination date, type of vaccine received, and signature of the healthcare provider who administered the vaccine.