Canada Seasonal Influenza and Pneumococcal Immunization Consent Form - Manitoba 2020-2025 free printable template

Seasonal Influenza and Pneumococcal Immunization Consent Form Clear All Regionalistic LocationDateSECTIONS A, B, C AND D COMPLETED BY: ClientParentLegal decision makeover(on behalf of client)A. Client

How to fill out seasonal influenza and pneumococcal

How to fill out Canada Seasonal Influenza and Pneumococcal Immunization Consent

1. Obtain the Canada Seasonal Influenza and Pneumococcal Immunization Consent form from a healthcare provider or online.
2. Read the instructions and information provided on the form carefully.
3. Fill out the personal information section, including your name, address, and date of birth.
4. Provide information regarding any past immunizations, allergies, or medical conditions that may affect the immunization.
5. Indicate your consent for the vaccines by signing and dating the form.
6. Return the completed form to the healthcare provider administering the vaccine.

Who needs Canada Seasonal Influenza and Pneumococcal Immunization Consent?

1. Individuals 6 months of age and older who are receiving seasonal influenza and pneumococcal vaccinations.
2. Healthcare workers and caregivers in contact with high-risk populations.
3. Individuals with chronic medical conditions or weakened immune systems.
4. Elderly individuals, typically those aged 65 and older.

People Also Ask about

What are the current pneumonia vaccine guidelines?

CDC recommends routine administration of pneumococcal conjugate vaccine (PCV15 or PCV20) for all adults 65 years or older who have never received any pneumococcal conjugate vaccine or whose previous vaccination history is unknown: If PCV15 is used, this should be followed by a dose of PPSV23 one year later.

Is PCV13 no longer recommended?

Two new pneumococcal conjugate vaccines (PCV15 and PCV20) are now recommended as pneumococcal vaccination options for all adults age 65 and older and for adults age 19 through 64 with certain medical conditions or other risk factors for pneumococcal disease; ACIP no longer recommends PCV13 for adults.

What is replacing Prevnar 13?

PREVNAR 20® is Pfizer's next-generation pneumococcal conjugate vaccine that includes capsular polysaccharide conjugates for the 13 serotypes (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F) already included in Prevnar 13® (Pneumococcal 13-valent Conjugate Vaccine [Diphtheria CRM197 Protein]).

Why is PCV13 no longer recommended?

Because PCV13-type disease is at historically low levels among adults ≥65 years and most pneumococcal disease among these adults is due to non-PCV13 serotypes, ACIP no longer recommends their routine vaccination with PCV13.

Should I get pneumonia vaccine yes or no?

Studies* show that getting at least 1 shot of PCV13 protects: At least 8 in 10 babies from serious infections called invasive pneumococcal disease. 3 in 4 adults 65 years or older against invasive pneumococcal disease. 9 in 20 adults 65 years or older against pneumococcal pneumonia.

Do you need both Prevnar 13 and Pneumovax 23?

The Centers for Disease Control and Prevention ( CDC ) recommends that adults 65 years of age or older receive a single dose of Prevnar 13 in addition to the Pneumovax. Prevnar 13 should be given first and the Pneumovax a year later.

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What is Canada Seasonal Influenza and Pneumococcal Immunization Consent?

Canada Seasonal Influenza and Pneumococcal Immunization Consent is a form that individuals must complete to provide permission for vaccination against seasonal influenza and pneumococcal diseases. It ensures that the person receiving the vaccine understands the benefits, risks, and any alternatives.

Who is required to file Canada Seasonal Influenza and Pneumococcal Immunization Consent?

Individuals who are receiving the seasonal influenza or pneumococcal vaccination are required to file the consent. This includes children, adults, and elderly individuals receiving the vaccine, as well as their guardians in cases of minors.

How to fill out Canada Seasonal Influenza and Pneumococcal Immunization Consent?

To fill out the consent form, individuals or guardians must provide personal information, indicate any allergies or medical conditions, and sign to confirm their acknowledgment of the vaccine's benefits and risks. It is important to read the form carefully and ask questions if anything is unclear.

What is the purpose of Canada Seasonal Influenza and Pneumococcal Immunization Consent?

The purpose of the consent is to ensure that individuals are informed about the vaccines they are receiving, to document their consent, and to protect healthcare providers legally by confirming that the individual understands and agrees to the vaccination.

What information must be reported on Canada Seasonal Influenza and Pneumococcal Immunization Consent?

The information that must be reported includes the individual's name, date of birth, contact information, medical history, any allergies, the date of the vaccine, and the name of the healthcare provider administering the vaccine.