Get the free Bacterial Meningitis Immunization Record - wtamu

This document serves as a record for first-time, transferring, or returning students to provide proof of vaccination against bacterial meningitis prior to attending an institution of higher education.

How to fill out bacterial meningitis immunization record

How to fill out Bacterial Meningitis Immunization Record

1. Obtain the Bacterial Meningitis Immunization Record form from your healthcare provider or school.
2. Fill in your personal information such as name, date of birth, and contact details at the top of the form.
3. Record the date you received the bacterial meningitis vaccine in the appropriate section.
4. Provide details of the healthcare provider who administered the vaccine, including their name and signature.
5. If applicable, include any additional doses received, along with corresponding dates and provider information.
6. Review the completed form for accuracy and ensure that all sections are filled out correctly.
7. Submit the completed immunization record to your educational institution or healthcare provider as required.

Who needs Bacterial Meningitis Immunization Record?

1. College or university students living in dormitories.
2. Individuals entering certain healthcare programs or professions.
3. Adolescents and young adults, typically between the ages of 11 and 18, as part of routine vaccinations.
4. Travelers to areas where the disease is common or during outbreaks.

People Also Ask about

What is the meningitis vaccine called on immunization records?

A3: One dose of meningococcal conjugate vaccine (MenACWY; sometimes abbreviated as MCV4; brand names Menactra, Menveo, or MenQuadfi) is required for entry into grades 7 through 11. Q4: How many doses of meningococcal vaccine are required for grade 12?

What is another name for meningitis vaccine?

MenACWY vaccines (Menveo® and MenQuadfi®) help protect against 4 serogroups of the bacteria that cause meningococcal disease: A, C, W, and Y. This type of vaccine is also known as a serogroup A, C, W, and Y, or quadrivalent, meningococcal vaccine.

What is meningitis vaccine called on shot record?

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.

What are initials for meningitis vaccine?

MenACWY vaccine for students It protects against four types of meningitis – MenA, MenC, MenW and MenY. However, you may have missed this vaccine – you can check whether you've it by contacting your GP or checking the NHS app.

How to get proof of bacterial meningitis vaccination?

What are the acceptable forms of evidence? A Proof of Bacterial Meningitis Immunization Compliance Form containing the required information with the signature or stamp of a physician or his/her designee, or public health personnel*. An official immunization record is generated from a state or local health authority.

Are MCV4 and MenACWY the same?

College students living in dorms and military members in barracks are at higher risk,” Messina explains. “Sharing cigarettes or drinks, kissing or other intimate contact also increase risk.” The symptoms of meningitis B can mimic the flu with non-specific complaints such as nausea, muscle pain and fever.

For pdfFiller’s FAQs

What is Bacterial Meningitis Immunization Record?

It is a document that verifies an individual's vaccination history against bacterial meningitis, specifically detailing the receipt of the meningococcal vaccine.

Who is required to file Bacterial Meningitis Immunization Record?

Typically, students entering college or certain educational institutions are required to file this record to ensure they are protected against bacterial meningitis.

How to fill out Bacterial Meningitis Immunization Record?

The record should be filled out by a healthcare provider, including the date of vaccination, type of vaccine received, and any other relevant identification information.

What is the purpose of Bacterial Meningitis Immunization Record?

The purpose is to provide proof of vaccination status to educational institutions, ensuring the safety and health of the student population.

What information must be reported on Bacterial Meningitis Immunization Record?

It must include the individual's name, date of birth, date of vaccination, type of vaccine administered, and the name of the healthcare provider who administered the vaccine.