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Scanned in QS1 Immunization Record Faxed Dr/Hepatitis B Vaccine Consent Form (HEPLISAVB) Must be 18 years of age or older Must remain in pharmacy for 15 minutes after injectionPERSONAL INFORMATION

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How to fill out heplisav-b

01

To fill out Heplisav-B, follow these steps:

02

Start by reading and understanding the instructions provided with the vaccine.

03

Gather all the necessary materials, including the vaccine vial, sterile syringe, and needle.

04

Ensure proper hygiene by washing your hands thoroughly with soap and water.

05

Prepare the vaccine by checking the expiration date and shaking the vial gently.

06

Use a sterile syringe to withdraw the correct dosage of the vaccine from the vial.

07

Choose an injection site, usually the upper arm, and clean it with an alcohol swab.

08

Use a quick, dart-like motion to insert the needle into the muscle at a 90-degree angle.

09

Slowly push the plunger to administer the vaccine into the muscle.

10

Once the vaccine is fully injected, carefully remove the needle and dispose of it in a sharps container.

11

Gently apply pressure to the injection site with a sterile cotton ball to prevent bleeding.

12

Dispose of all used materials properly and wash your hands again.

13

Monitor the injection site for any adverse reactions or side effects.

14

Note: It is always recommended to consult with a healthcare professional for specific instructions and guidance on filling out Heplisav-B.

Who needs heplisav-b?

01

Heplisav-B is a hepatitis B vaccine that is recommended for:

02

- Individuals at risk for hepatitis B infection, including healthcare workers, patients with chronic kidney disease, and immunocompromised individuals.

03

- Adults aged 18 years and older who have not previously been vaccinated against hepatitis B.

04

- Those who require protection against hepatitis B due to their occupation or lifestyle.

05

- People traveling to regions with high hepatitis B prevalence.

06

It is important to consult with a healthcare professional to determine if Heplisav-B is suitable and necessary for your specific situation.

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What is heplisav-b?

Heplisav-B is a vaccine used to help prevent infection caused by hepatitis B virus.

Who is required to file heplisav-b?

Healthcare providers are required to file heplisav-b after administering the vaccine.

How to fill out heplisav-b?

Heplisav-B should be filled out with the relevant patient information, vaccine administration details, and healthcare provider's information.

What is the purpose of heplisav-b?

The purpose of heplisav-b is to document the administration of the hepatitis B vaccine.

What information must be reported on heplisav-b?

Information such as patient name, date of birth, date of vaccine administration, vaccine lot number, and healthcare provider's signature must be reported on heplisav-b.

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