Get the free Meningococcal Vaccine Form - njms umdnj

This form is required for students residing in University residence halls to provide proof of meningococcal vaccination as mandated by New Jersey state law and UMDNJ policy.

How to fill out meningococcal vaccine form

How to fill out Meningococcal Vaccine Form

1. Obtain the Meningococcal Vaccine Form from your healthcare provider or the relevant health authority.
2. Fill in your personal information such as your name, date of birth, and contact details.
3. Provide information about your medical history, including any allergies or previous reactions to vaccines.
4. Indicate the specific type of Meningococcal vaccine you are receiving.
5. Sign and date the form to verify that the information you provided is accurate.
6. Submit the completed form to your healthcare provider, school, or organization requiring the vaccination documentation.

Who needs Meningococcal Vaccine Form?

1. Students entering college or university, particularly if living in dormitories.
2. Individuals traveling to countries where Meningococcal disease is common.
3. Those who are part of outbreak response requirements.
4. Certain military recruits or individuals in similar communal living situations.
5. Patients with specific medical conditions as advised by their healthcare provider.

People Also Ask about

What is the full form of MenACWY?

The meningitis ACWY (MenACWY) vaccine helps protect against meningitis and septicaemia (blood poisoning). These infections are caused by meningococcal bacteria groups A, C, W and Y. Young people have a higher risk of getting meningococcal disease.

Is Menactra the same as MCV?

Menveo [Meningococcal (Groups A, C, Y and W-135) Oligosaccharide Diphtheria CRM197 Conjugate Vaccine] is an immunization used to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y and W-135.

What is another name for the MCV vaccine?

One type of MCV4, Menveo, is licensed for use in people ages 2 to 55. Another version, Menactra, is approved for those 9 months to 55 years old. MPSV4 is the only vaccine licensed for use in people over 55 as well as people 2 to 55. Both vaccines protect against four types of meningococcal disease.

What is meningococcal also known as?

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.

What is the meningococcal vaccine in English?

Meningococcal vaccine is an active immunizing agent used to prevent infection caused by certain groups of meningococcal bacteria (Neisseria meningitides). The vaccine works by causing your body to produce its own protection (antibodies) against the disease.

Is MCV the same as meningococcal?

While both the meningitis vaccines (ACWY and B) are listed on the CDC's list of recommended vaccinations, the serogroup B meningococcal vaccine, which provides immunity for meningitis B, is less often required for school/college admission.

For pdfFiller’s FAQs

What is Meningococcal Vaccine Form?

The Meningococcal Vaccine Form is a document used to record immunization against meningococcal disease, which is vital for tracking vaccination status and ensuring public health safety.

Who is required to file Meningococcal Vaccine Form?

Individuals, typically students or people entering certain healthcare or academic institutions, are required to file the Meningococcal Vaccine Form to confirm their vaccination status.

How to fill out Meningococcal Vaccine Form?

To fill out the Meningococcal Vaccine Form, you need to provide personal information, vaccination dates, healthcare provider details, and sign to confirm the information is accurate.

What is the purpose of Meningococcal Vaccine Form?

The purpose of the Meningococcal Vaccine Form is to document vaccination history, facilitate entry into schools or camps, and contribute to public health efforts in controlling meningococcal disease.

What information must be reported on Meningococcal Vaccine Form?

Information that must be reported includes the individual's name, date of birth, vaccination dates, type of vaccine received, and the name of the healthcare provider who administered the vaccine.