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WEST ALLIS HEALTH DEPARTMENT INFLUENZA VACCINE ADMINISTRATION RECORD (MINOR) Part I. Personal Information for Person to Receive Vaccine PLEASE PRINT Last Name First Name Street Address MI: Apt # City

How to fill out influenza vaccine administration record

How to fill out an influenza vaccine administration record:

1. Start by filling in the patient's personal information, including their full name, date of birth, and contact information. This ensures that the record is properly associated with the correct individual.
2. Next, document the date and location where the influenza vaccine was administered. This helps to track the timing and place of the vaccination.
3. Record the type of influenza vaccine given. There are different types of influenza vaccines available, such as the flu shot or nasal spray. Specify the exact type administered for accurate documentation.
4. Include the lot number and expiration date of the vaccine. This information is important for traceability and quality control purposes.
5. Indicate the dose and route of administration. The influenza vaccine may be administered as a single dose or may require multiple doses. Specify whether it was given intramuscularly (injected into the muscle) or intranasally (through the nose).
6. Note the name and credentials of the healthcare professional administering the vaccine. This helps to identify responsibility and verify the legitimacy of the administration.
7. Finally, ensure that the influenza vaccine administration record is signed and dated by the healthcare professional. This serves as a confirmation that the vaccine was properly administered and can be used for future reference.

Who needs an influenza vaccine administration record?

1. Individuals receiving the influenza vaccine, regardless of age, should ideally have an administration record. This helps to maintain an accurate vaccination history and aids in monitoring vaccine efficacy.
2. Healthcare facilities and providers require an administration record to maintain a comprehensive record of the vaccines administered to patients. This documentation is crucial for tracking vaccine inventory, tracing adverse events, and ensuring compliance with vaccination guidelines.
3. Employers and educational institutions often request immunization records, including specifics of the influenza vaccine, to ensure a healthy and safe environment for their employees and students.

In summary, filling out an influenza vaccine administration record involves documenting personal information, vaccine details, administration details, and the healthcare professional involved. This record is necessary for patients, healthcare providers, employers, and educational institutions to track vaccination history and ensure compliance with immunization guidelines.

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What is influenza vaccine administration record?

The influenza vaccine administration record is a document that records the details of administering the influenza vaccine to individuals.

Who is required to file influenza vaccine administration record?

Healthcare providers and facilities that administer the influenza vaccine are required to file the administration record.

How to fill out influenza vaccine administration record?

To fill out the influenza vaccine administration record, the healthcare provider must record the patient's information, vaccine details, date of administration, and any adverse reactions.

What is the purpose of influenza vaccine administration record?

The purpose of the influenza vaccine administration record is to maintain a record of vaccine administration for each individual, track vaccination rates, and monitor any adverse reactions.

What information must be reported on influenza vaccine administration record?

The information that must be reported on the influenza vaccine administration record includes patient's name, date of birth, vaccine manufacturer and lot number, date of administration, and any adverse reactions.