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For 65+ years only: Flu zone High Dose Influenza Vaccine Registration Form ***PLEASE PRINT LEGIBLY**** Scan both sides & email to: Panoramareportimms@health.gov.sk.ca or fax to 3067876296 or 3067876259

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How to fill out high dose influenza vaccine

01

Check with your healthcare provider to determine if you are eligible for the high dose influenza vaccine.

02

Schedule an appointment with your healthcare provider or visit a vaccination clinic.

03

Provide your personal and medical information to the healthcare provider.

04

Roll up your sleeve so the healthcare provider can administer the vaccine in your upper arm muscle.

05

Stay at the clinic for a few minutes to monitor for any adverse reactions.

06

Follow up with your healthcare provider if you experience any side effects or have concerns.

Who needs high dose influenza vaccine?

01

Individuals aged 65 years and older are recommended to receive the high dose influenza vaccine as they have a higher risk of severe complications from the flu.

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What is high dose influenza vaccine?

High dose influenza vaccine is a flu vaccine that contains four times the amount of antigen (the active ingredient that prompts the body to produce antibodies) as a regular flu shot, specifically designed for people 65 years and older.

Who is required to file high dose influenza vaccine?

High dose influenza vaccine is recommended for individuals aged 65 years and older, as they are at higher risk of serious complications from the flu.

How to fill out high dose influenza vaccine?

High dose influenza vaccine can be administered by a healthcare provider through an injection in the arm.

What is the purpose of high dose influenza vaccine?

The purpose of high dose influenza vaccine is to provide better immune response in older adults, reducing the risk of severe illness and hospitalization due to the flu.

What information must be reported on high dose influenza vaccine?

Information such as the date of vaccination, the manufacturer and lot number of the vaccine, and the healthcare provider's name and address must be reported on high dose influenza vaccine.

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