Get the free Meningococcal Meningitis and Hepatitis B Immunization Health History Form - tnstate
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This form collects health history regarding Hepatitis B and Meningococcal Meningitis vaccinations for new students enrolling in postsecondary institutions, as mandated by Tennessee law.
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How to fill out meningococcal meningitis and hepatitis
How to fill out Meningococcal Meningitis and Hepatitis B Immunization Health History Form
01
Obtain a copy of the Meningococcal Meningitis and Hepatitis B Immunization Health History Form.
02
Start by filling out the personal information section, including your name, date of birth, and contact details.
03
Provide the names of any healthcare providers you have visited for immunizations.
04
List all previous vaccinations related to Meningococcal Meningitis and Hepatitis B, including dates and types.
05
Indicate any allergies you may have to medications or vaccines.
06
Answer any questions related to your medical history, including any past illnesses or conditions.
07
Review your completed form for accuracy and completeness.
08
Sign and date the form as required.
Who needs Meningococcal Meningitis and Hepatitis B Immunization Health History Form?
01
Students entering college or university.
02
Individuals planning to travel to areas where Meningococcal Meningitis is common.
03
Healthcare workers who may be at risk of exposure.
04
Individuals with certain medical conditions that increase the risk of Meningococcal Meningitis or Hepatitis B.
05
Parents or guardians filling out the form for minors receiving vaccinations.
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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 required for individuals to report their immunization status against Meningococcal Meningitis and Hepatitis B, including vaccination dates and the healthcare provider details.
Who is required to file Meningococcal Meningitis and Hepatitis B Immunization Health History Form?
Typically, students living in on-campus housing, as well as certain other groups such as new enrollees and individuals working in specific health-related fields, are required to file this form.
How to fill out Meningococcal Meningitis and Hepatitis B Immunization Health History Form?
To fill out the form, individuals should provide personal identification information, vaccination dates for Meningococcal Meningitis and Hepatitis B, and the name and contact information of the healthcare provider who administered the vaccines.
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 vaccinated against Meningococcal Meningitis and Hepatitis B for their protection and public health, as well as to meet institutional health requirements.
What information must be reported on Meningococcal Meningitis and Hepatitis B Immunization Health History Form?
The form must report personal information, vaccination dates for Meningococcal Meningitis and Hepatitis B, any previous medical history relevant to these vaccines, and the contact details of the administering healthcare provider.
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