Get the free Tdap Cocoon Program VACCINE ORDER FORM (VOF) - CT.gov

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Trap Cocoon Program VACCINE ORDER FORM (OF) IMMUNIZATION PROGRAM 1. 2. 3. 4. 5. This form MUST reach our office on or before the 1st business day of the month. Late orders will not be processed. FAX

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How to fill out tdap cocoon program vaccine

01

To fill out the tdap cocoon program vaccine, follow these steps:

02

Gather the necessary information: You will need the person's name, date of birth, and contact information.

03

Complete the medical history: Provide details about any previous vaccinations, allergies, or medical conditions.

04

Review the consent form: Ensure that the person understands the purpose and possible side effects of the vaccine.

05

Administer the vaccine: Follow the recommended dosage and injection technique.

06

Document the vaccination: Record the date, lot number of the vaccine, and the administering healthcare professional's information.

07

Provide aftercare instructions: Advise the person on any potential side effects or necessary precautions.

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Schedule follow-up appointments if needed: Discuss any booster shots or additional vaccines required.

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Keep records: Maintain a copy of the completed form for future reference or for sharing with other healthcare providers.

Who needs tdap cocoon program vaccine?

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The tdap cocoon program vaccine is recommended for the following individuals:

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- Pregnant women: To protect both the mother and the newborn from pertussis (whooping cough).

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- Close contacts of infants: Such as parents, siblings, grandparents, and caregivers who will be in regular contact with newborns.

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- Healthcare workers: Especially those who are in direct contact with infants or who work in settings where the risk of pertussis transmission is high.

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- Adults who have not been previously vaccinated or have incomplete vaccination history.

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