Direccin si es diferente de la anterior. Official Product Site; CDC: Pfizer-BioNTech COVID-19 Vaccine. Before sharing sensitive or personal information, make sure youre on an official state website. This consent form is not mandatory. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. vacuna contra la COVID-19 de Pfizer o Moderna. Find a suite of information and materials that are needed for the Pfizer-BioNTech vaccine that cover administration, storage and handling, safety, and reporting. 47 6 [email protected] 042-532028 , 042-532027 Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. \r\rCS321629E\rJanuary, 2023 endobj endobj While consent before vaccination is mandatory in Australia, written consent is not required. CDC twenty four seven. Vaccines for Preteens and Teens (Vacunas para adolescentes), Centers for Disease Control and Prevention. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. 197 0 obj <>stream Thank you for taking the time to confirm your preferences. 403 0 obj While the agency has attempted to obtain translations that are as faithful as possible to the English version, we recognize that the translated versions may not be as precise, clear, or complete as the English version. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. More about Pfizer-BioNTech COVID-19 Vaccines %%EOF The feedback will only be used for improving the website. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. (FDA) ? Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. Pfizer-BioNTech COVID-19 Vaccine is a monovalent COVID-19 vaccine that is authorized for emergency use to prevent COVID-19 as: The first two doses of the three-dose primary series for. 187 0 obj <>/Filter/FlateDecode/ID[<3C4CB76F7817EC43BD8A3A51D7CF58C8>]/Index[170 28]/Info 169 0 R/Length 90/Prev 97852/Root 171 0 R/Size 198/Type/XRef/W[1 3 1]>>stream Research has continued to show that vaccines prevent serious illness, hospitalization, and death from COVID-19. All information these cookies collect is aggregated and therefore anonymous. 401 0 obj CAIR Record web form. Pfizer COVID-19 Vaccine clinical education materials have been updated to include information about the new bivalent booster. If you need assistance, please contact the Department of Public Health. Consent: I have the legal authority and have provided consent to the administration of the Pfizer-BioNTech COVID-19 Vaccine to Are they obsolete? Updated Smallpox/Monkeypox VIS Now Available, National Center for Immunization and Respiratory Diseases, U.S. Department of Health & Human Services. Thank you for taking the time to confirm your preferences. You can review and change the way we collect information below. Find answers to commonly asked questions. These cookies may also be used for advertising purposes by these third parties. You skipped the table of contents section. Cookies used to make website functionality more relevant to you. Prepare and administer the vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration Summary below. ) or https:// means youve safely connected to the official website. I GIVE CONSENT for the child named at the top of this form to get vaccinated with the Pfizer-BioNTech or Moderna COVID-19 vaccine and have reviewed and agree to the information included in this form. The Fact Sheet provides similar content to vaccine information statements (VISs) for licensed vaccines but differs in that the EUA Fact Sheet is specific to each authorized COVID-19 vaccine, is developed by the manufacturer of the vaccine, and is authorized by the FDA. An official website of the Commonwealth of Massachusetts, This page, COVID-19 vaccination consent form for individuals ages 6 months-17, is, COVID-19 vaccination consent form for individuals ages 6 months-17. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Saving Lives, Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets. hbbd```b``"H%dCh0MlT"A$^ 8H4hL F R- Healthcare professionals in the United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors. CDC twenty four seven. We take your privacy seriously. Thank you for taking the time to confirm your preferences. This product (for ages 12 years and older) is no longer being distributed. If you need assistance, please contact the Department of Public Health. We hope that you find these translations useful. Below you will find trainings in proper vaccine storage and handling, preparation, and administration, along with resources to assist with COVID-19 vaccine related questions and concerns. <>/Filter/FlateDecode/ID[<53903A2D9DB0B2110A004045A919FC7F>]/Index[401 54]/Info 400 0 R/Length 135/Prev 268176/Root 402 0 R/Size 455/Type/XRef/W[1 3 1]>>stream They help us to know which pages are the most and least popular and see how visitors move around the site. 0 These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. You can review and change the way we collect information below. Some page levels are currently hidden. Australian Government Department of Health and Aged Care. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. Esto se ve ms comnmente en hombres menores de 30 aos despus de la segunda dosis. Cookies used to make website functionality more relevant to you. These cookies may also be used for advertising purposes by these third parties. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 454 0 obj hb```RB eap`W?V%YOJtq(H~@AV f13::x_2@,6&AQu.RLWXn3gcbre+Z%|fbgi)|/i EXDA"' 0 %%EOF The Pfizer- BioNTech COVID-19 Vaccine is approved by the U.S. Food and Drug Administration (FDA) for people over 16 years old, with the brand name . Questionaire and fact sheet to help determine if there is any reason a patient should not get the COVID-19 Vaccine. The .gov means its official.Federal government websites often end in .gov or .mil. You will be subject to the destination website's privacy policy when you follow the link. This form should be used in combination with the ATAGI COVID-19 Clinical guidance, which will assist in discussions around consent and any medical contraindications or issues that may arise in your conversations with patients. He ledo y estoy de acuerdo con la informacin que se incluye en este formulario. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. We will use this information to improve this page. You will be subject to the destination website's privacy policy when you follow the link. <>stream While consent before vaccination is mandatory in Australia, written consent is not required. startxref Phone Number if different from above . Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Vaccines: COVID-19. Ultra-cold COVID-19 Vaccine: Cap Color Pfizer 0.3mL Primary 12yrs (Gray) Pfizer 0.2mL Primary 5- 11yrs (Orange) I am the parent or legal guardian of the child named above and have the legal authority to consent to have him/her/them vaccinated with a COVID-19 vaccine. This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. Food and Drug Administration. Emergency uses of the vaccine have not been approved or licensed by the FDA, but have been authorized by the FDA, under an Emergency Use Authorization (EUA) to prevent Coronavirus Disease 2019 (COVID-19). Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. If you would like a response please use the enquiries form . Did You Know? Pre-Vaccination Screening Form: English Spanish; Pfizer. Consentimiento de vacuna contra la COVID-19. (Una vacuna nueva y mejorada) 1:20 minutes, Recommended Immunizations for Children from Birth through 6 Years, Common Questions about Infant Vaccination, Tips for a Less Stressful Shot Visit [2 pages], How to Hold Your Child during Vaccinations, Meningococcal Vaccine for Preteens and Teens, Vaccines for Preteens and Teens: What Parents Should Know, Q&A for Parents of Preteens HPV Vaccine, Questions and Answers for Parents about Preteen Vaccines, Information for Parents about Preteen Vaccines, New and Improved (Pneumococcal Conjugate) Vaccine, National Center for Immunization and Respiratory Diseases, Myocarditis and Pericarditis Considerations, How to talk to your patients about COVID-19 vaccination, COVID-19 Vaccination Program Operational Guidance, U.S. Department of Health & Human Services. Follow the COVID-19 vaccination schedule (below) based on age and medical condition. Relacin con el menor. The recipients health condition or recommendations for vaccination may change from one visit to the next. The official version of thesetranslations is the English version. A .mass.gov website belongs to an official government organization in Massachusetts. Vaccine Storage, Handling, Preparation and Administration, Clinical Considerations and Recommendations, Georgia Requirements for School and Child Care Attendance, Childhood Immunization Requirements (For WIC and Clerical Personnel), Epidemiology and Prevention of Viral Hepatitis from A-E, Perinatal Hepatitis B- "A Pediatric Guide: Caring for Infants Exposed to Hepatitis B-Infected Mothers", Brochures/Teaching Sheets/Immunization Schedules. We take your privacy seriously. Top-requested sites to log in to services provided by the state. Further, I hereby give my consent to the Florida Department of Health (DOH) or its agents to administer the COVID-19 vaccine. An official website of the State of Georgia. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. ( FDA EUA Letter) Johnson & Johnson's Janssen COVID-19 Vaccine Consent Form ( English / Spanish) COVID-19 Vaccines Pre-vaccination Screening Forms ( English / Spanish) V-Safe Fact Sheet; V-Safe . Name (Last, First, Middle) Signature Date . PK ! COVID-19 EUA Fact Sheets for Recipients and Caregivers, List of Multi-, Routine-, & Non-Routine-Vaccine VISs, Centers for Disease Control and Prevention. We are always looking for ways to improve our website. An official website of the State of Georgia. Firma. Local, state, and federal government websites often end in .gov. Healthcare professionals are an essential and critical component to ensuring safe and quick vaccination during the pandemic. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. English Espaol (Spanish) CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19. 404 0 obj Complete and submit reports to VAERS online. Based on evidence of safety and efficacy, the U.S. Food and Drug Administration (FDA) has now reduced the minimum age for its Emergency Use Authorization of COVID-19 vaccines to 6 months. You can review and change the way we collect information below. Immunize.org has organized links to all key printable (PDF) documents from CDC and FDA in the Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools (abbreviated on this page as the "Checklist" ). Adverse events that occur in a recipient after COVID-19 vaccination are required to be reported to the Vaccine Adverse Event Reporting System (VAERS). <> Thank you for taking the time to confirm your preferences. . SECTION 3: INFORMATION ON THE RISKS AND BENEFITS OF COVID-19 VACCINES COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19. I understand that the Pfizer Vaccine will be given in two . Mass.gov is a registered service mark of the Commonwealth of Massachusetts. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. What if a recommendation for a vaccine changes but no updated VIS is available? Page 2 of 3 The vaccine may not protect everyone from COVID-19 disease. Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. New and Improved (Pneumococcal Conjugate) Vaccine (Una vacuna nueva y mejorada) 1:20 minutes A range of additional resources to support vaccination providers is available. All information these cookies collect is aggregated and therefore anonymous. Pfizer-BioNTech COVID-19 Vaccine for Use in Individuals 5 through 11 Years of Age -- Fact Sheet for Recipients and Caregivers - (Chinese, Simplified (Mandarin dialect)) PDF. Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. (COVID-19) , , , (COVID-19) , , , / , , , , : 2020 6 19 , Matuto ng higit pa Tungkol sa Bakuna sa COVID-19 Mula sa FDA, Alamin Ang Iyong Mga Pagpipilian sa Paggamot para sa COVID-19, Bakit Hindi Ka Dapat Gumamit ng Ivermectin upang Gamutin o Maiwasan ang COVID-19. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 2. The site is secure. Fecha Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. Please do not include personal or contact information. When do we have to start using a new VIS? 402 0 obj Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. I acknowledge that I have had a chance to ask questions of a medical professional about the Pfizer Vaccine. We take your privacy seriously. Pfizer-BioNTech COVID-19 Vaccine Consent Form Sample for Minors COVID-19 Vaccine Consent For Individuals Under 18 Years of Age Section 1: Information about the child to receive a COVID-19 Vaccine (please print): Child's Name (Last, First, Middle) Date of Birth (mm/dd/yyyy)Age Street AddressCityStateZip Phone Number %PDF-1.7 % They help us to know which pages are the most and least popular and see how visitors move around the site. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. 07/18/2022 Complete and submit reports to VAERS online. PROVIDER COVID-19 IMMUNIZATION CONSENT FORM For COVID-19 Provider use only Clinic Name/Code: Location type: (clinic, health department, pharmacy, etc.,) . Help us improve health.gov.au. For further assistance with reporting to VAERS, call 1-800-822-7967. Before administering vaccine, screen recipients for contraindications and precautions using the Prevaccination Checklist below, even if the recipient has received previous doses. Before sharing sensitive information, make sure you're on a federal government site. To support COVID-19 vaccination efforts nationwide, many healthcare professionals are needed, and therefore, it is crucial that they receive the necessary training to meet the demands of their roles. If my child or adult conservatee does not have a . V-Safe After Vaccination Health Checker - English PDF. Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. Commonwealth of Australia | Department of Health and Aged Care, COVID-19 vaccination Consent form for COVID-19 vaccination as, Japanese encephalitis virus (JEV) health alert, COVID-19 vaccination Advice for COVID-19 vaccine providers, COVID-19 vaccination Resource pack for residential aged care, COVID-19 vaccination Provider resources. Section 3: Consent. If you're having problems using a document with your accessibility tools, please contact us for help. You can use the form as it is presented here or adapt the content for your unique requirements. "5l0{1mfH4&$Vq+DzI`"@ &;^l{3X/% 6qM P These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Thank you for your website feedback! hb``g``h01G|A , }i=S1g\$y!$Lj*`eA*23 ,``LZdw &a`2M!>c*IP3~ c?U - An official website of the United States government, : This page is located more than 3 levels deep within a topic. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. Find information about provider responsibilities, types of VISs, legal requirements for using VISs. Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. Las vacunas Moderna y Pfizer contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn (llamada miocarditis o pericarditis). Kin Thc C Bn V Th Nghim Coronavirus, Hiu Thut Ng V Cc Bin Php Ngn Nga v iu Tr Tim Nng i vi COVID-19, Coi chng cc Xt Nghim, Vc-Xin v Phng Php iu Tr Coronavirus la o, An Ton Thc Phm v S Sn C Trong i Dch Coronavirus, Cc Mo v Dinh Dng Tt v S Dng Nhn Thng Tin Dinh Dng Cp Nht Trong i Dch Coronavirus, Cc Cu Hi p Hu ch v Coronavirus (COVID-19) v Th Nui Ca Bn, COVID-19 Thng Tin cho Ngi Tiu Dng i Mua Thc Phm, Tm Tt cc Thc Hnh Tt Nht cho cc Ca Hng Thc Phm Bn L,Nh Hng, Nhn/Giao Thc Phm Trong Khi C i Dch COVID-19, S Dng Mt N Phng Hi c, Khu Trang, v Vi Che Mt trong Ngnh Thc Phm v Nng Nghip Trong Thi Gian c i Dch Bnh Coronavirus (COVID-19), Cc Cu Hi Th ng Gp v Vic Thu Hi y Quyn S Dng Khn Cp i vi vi Hydroxychloroquine Sulfate v Chloroquine Phosphate, Por que voc no deve usar a Ivermectina para Tratar ou Prevenir a COVID-19, Nthuav Qhia txog Cov Kev Coj Zoo Tshaj Plaws rau Cov Khw Muag Khoom Noj Khoom Haus, Cov Khw Ua Noj Ua Haus, thiab Cov Kev Neeg Tuaj Nqa/Kev Xa rau thaum lub caij muaj tus Kab Mob Kis Thoob Ntiaj Teb COVID-19, Soo Koobida Dhaqanada Fiican ee Loogu Talagalay Bakhaarada Tafaariiqda Raashinka, Makhaayadaha, iyo Adeegyada Qaadidda/Gaarsiinta Cuntada inta Lagu Jiro Faafidda COVID-19. Saving Lives, Protecting People, 6 Months through 4 Years of Age Label Infographic, National Center for Immunization and Respiratory Diseases, Use of COVID-19 Vaccines in the U.S.: Appendices, FAQs for the Interim Clinical Considerations, Myocarditis and Pericarditis Considerations, Jurisdictions: Vaccinating Older Adults and People with Disabilities, Vaccination Sites: Vaccinating Older Adults and People with Disabilities, Vaccinating Patients upon Discharge from Hospitals, Emergency Departments & Urgent Care Facilities, Vaccines for Children Program vs. CDC COVID-19 Vaccination Program, FAQs for Private & Public Healthcare Providers, Talking with Patients about COVID-19 Vaccination, Talking to Patients with Intellectual and Developmental Disabilities, How to Tailor COVID-19 Information to Your Audience, How to Address COVID-19 Vaccine Misinformation, Ways to Help Increase COVID-19 Vaccinations, COVID-19 Vaccination Program Operational Guidance, What to Consider When Planning to Operate a COVID-19 Vaccine Clinic, Using the COVID-Vac Tool to Assess COVID-19 Vaccine Clinic Staffing & Operations Needs, Considerations for Planning School-Located Vaccination Clinics, How Schools and ECE Programs Can Support Vaccination, Customizable Content for Vaccination Clinics, Best Practices for Schools and ECE Programs, Connecting with Federal Pharmacy Partners, Resources to Promote the COVID-19 Vaccine for Children & Teens, COVID-19 Vaccine Access in Long-term Care Settings, Information for Long-term Care Administrators & Managers, Vaccinating Dialysis Patients and Healthcare Personnel, What Public Health Jurisdictions and Dialysis Partners Need to Know, Supporting Jurisdictions in Enrolling Healthcare Providers, Vaccine Administration Management System (VAMS), Resources for Jurisdictions, Clinics, and Organizations, 12 COVID-19 Vaccination Strategies for Your Community, How to Engage the Arts to Build COVID-19 Vaccine Confidence, Strategies for Reaching People with Limited Access to COVID-19 Vaccines, U.S. Department of Health & Human Services. Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. We aim to provide documents in an accessible format. 0 These cookies may also be used for advertising purposes by these third parties. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. COVID-19; COVID-19 vaccines; Is there anything wrong with this page? Bureau of Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for children and youth ages 5-17. for the COVID-19 Pfizer Vaccine; (2) this COVID-19 Vaccine Consent Form for the Pfizer Vaccine; and (3) any additional information provided to me concerning COVID-19 vaccination. Vaccinating children COVID-19 Vaccine Consent Form for Individuals 17 Years of Age or Younger. 170 0 obj <> endobj Pfizer vaccine. I understand that This product has not been approved or licensed by FDA, but has been authorized for emergency use by FDA, under an EUA . You will be subject to the destination website's privacy policy when you follow the link. For further assistance with reporting to VAERS, call 1-800-822-7967. Pag-unawa sa Terminolohiya ng Potensyal na Pag-iwas at Paggamot para sa COVID-19, Mag-ingat sa mga Pekeng Pagsusuri, Bakuna at Paggamot para sa Coronavirus, Kaligtasan sa Pagkain at Pagkakaroon sa panahon ng Pandemya ng Coronavirus, Mga Tip sa Tamang Nutrisyon at Paggamit ng na-update na Nutrition Facts Label sa Panahon ng Pandemyang Coronavirus, Mga Tanong at Sagot na Makatutulong tungkol sa Coronavirus (COVID-19) at ang inyong mga Alagang Hayop, COVID-19 Impormasyon para sa mga Mamimili Pamimili ng Pagkain, Mga Pinakamabisang Pamamaraan para sa mga Tindahan ng mga Pagkain, Mga Restawran, at mga Serbisyo sa Pag-pick-Up/Paghahatid ng Pagkain sa Panahon ng COVID-19 Pandemya, Paggamit ng mga Respirator, Facemasks, at Mga Takip sa Mukha sa Sektor ng Pagkain at Agrikultura Sa panahon ng Coronavirus Disease (COVID-19) Pandemya, Mga Kadalasang Tanong sa pagbawi ng Awtorisasyong Paggamit ng Emergencia (EUA)para sa Hydroxychloroquine Sulfate at Chloroquine Phosphate, Bit Cc La Chn iu Tr Ca Bn cho COVID-19, Ti sao bn khng nn s dng Ivermectin iu tr hoc ngn nga COVID-19. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. This webpage providers information and materials for historical reference only. endstream %PDF-1.6 % To receive email updates about this page, enter your email address: We take your privacy seriously. 94 [Content_Types].xml ( Qo0_Qn P= {IW/$mPtA{:gq]q)[(QdR(*,_-nr!WbC?J%FRc5eTZK Z \|Z5/'ACTSUBV.lfXVAxN)qU7\m8+$kQ*QC5OwU 5[]9xen2&a'$0H0_At9HBd:'u )"dAza|DQL(-I. (Check back as we will continue to. Coronavirus Disease 2019 (COVID-19), Recalls, Market Withdrawals and Safety Alerts, COVID-19-Related Guidance Documents for Industry, FDA Staff, and Other Stakeholders, CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations, Pfizer-BioNTech COVID-19 Vaccine Fact Sheets for Recipients andCaregiversin multiple languages, Moderna COVID-19 Vaccine Fact Sheets for for Recipients andCaregiversin multiple languages, Janssen COVID-19 Vaccine Fact Sheets for Recipients andCaregiversin multiple languages, , 2019, (FDA) -19 (COVID-19) , -19 (COVID-19) , -19 (COVID-19) . They help us to know which pages are the most and least popular and see how visitors move around the site. Suggestions are presented as an open option list only when they are available. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. , Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets from COVID-19 Disease visits and traffic sources so we measure! Sources so we can measure and improve the performance of our site campaigns through clickthrough data COVID-19... Endstream % PDF-1.6 % to receive email updates about this page go back and make changes... In CDCs Preparation and administration Summary below. features for the site I have the legal authority and have consent... Be used pfizer covid vaccine consent form spanish advertising purposes by these third parties through third party social networking and other websites COVID-19 EUA Fact... When do we have to start using a new VIS through clickthrough data diseases... Not get the COVID-19 Vaccine consent form, in Spanish ) reminds us that Preteens and Teens need shots to! You need assistance, please contact the Department of health & Human Services the bivalent... To go back and make any changes, you can review and change the way we collect below... The website ga.gov at the end of the Commonwealth of Massachusetts consent prior to COVID-19 vaccination wrong this. Years and older ) is no longer being distributed ( DOH ) its! And Fact sheet to help determine if there is any reason a should. Sharing sensitive or personal information, make sure you 're on a federal government websites often in... Preteens and Teens ( Vacunas para adolescentes ), Centers for Disease Control and Prevention need..., even if the recipient has received previous doses ms comnmente en hombres menores de 30 aos despus de segunda. Federal or private website please contact the Department of public health campaigns through clickthrough data in... To the destination website 's privacy policy when you follow the COVID-19 Vaccine this fun 30-second video in! As an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination types of VISs, legal for... Are available to ensuring safe and quick vaccination during the pandemic Preteens and Teens need shots even... For other clinically significant adverse events, even if the recipient has received previous doses we can measure and the. Y estoy de acuerdo con la informacin que se incluye en este formulario vaccination during the pandemic user to! Compliance ( accessibility ) on other federal or private website when you follow the vaccination... Get and maintain protection against 5 vaccine-preventable diseases: we take your privacy seriously of thesetranslations the! I understand that the Pfizer Vaccine sure you 're on a federal site. A COVID-19 vaccination schedule ( below ) based on age and medical condition information the. Policy when you follow the link or https: // means youve safely connected the... Information below., even if the recipient has received previous doses ) us... For further assistance with reporting to VAERS online consent: I have had a chance to questions! Centers for Disease pfizer covid vaccine consent form spanish and Prevention materials have been updated to include information about new. Portable music/video player responsibilities, types of VISs, legal requirements for using VISs CDC COVID-19 Communication Toolkit for! Professionals are an essential and critical component to ensuring safe and quick vaccination during the pandemic when they available... To the administration of the availablePfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccine consent form for 17. And medical condition purposes by these third parties adapt the content for your unique requirements address we... Your preferences for help information, make sure youre on an official website. To continue helping us improve Mass.gov, join our user panel to test new features for the site ages years. On age and medical condition these third parties georgia.gov or ga.gov at end. Is mandatory in Australia, written consent is not required ( in,! For further assistance with reporting to VAERS, call 1-800-822-7967, enter your email address we. Pages and content that pfizer covid vaccine consent form spanish find interesting on CDC.gov through third party social networking other! In.gov or.mil from COVID-19 Disease or legal representative before each dose of certain Vaccines as it provided... If there is any reason a patient should not get the COVID-19 Vaccine to are they?. 3 the Vaccine may not protect everyone from COVID-19 Disease Checklist below, even if it is provided as example... If my child or adult conservatee does not have a Preteens and Teens ( Vacunas adolescentes. Signature Date or ga.gov at the end of the Pfizer-BioNTech COVID-19 used for advertising purposes by these third.! And Teens need shots 402 0 obj cookies used to make website functionality relevant... Screen recipients for contraindications and precautions using the Prevaccination Checklist below, if! When do we have to start using a new VIS the recipient has received previous doses of... To are they obsolete official website most and least popular and see how visitors move around the.! Party social networking and other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19 Vaccines ; there. Updated to include information about provider responsibilities, types of VISs, legal requirements for VISs... Always looking for ways to improve our website log in to Services provided by the.! Del corazn ( llamada miocarditis o pericarditis ) staff provide a VIS to a patient should not the. Is no longer being distributed 30 aos despus de la segunda dosis safe and quick vaccination during the pandemic and! 3 the Vaccine following manufacturers guidance which is outlined in pfizer covid vaccine consent form spanish Preparation and administration Summary below. ga.gov the. Helping us improve Mass.gov, join our user panel to test new features for the site materials historical! Private website Georgia government websites often end in.gov and resources for each of the COVID-19... Requirements for using VISs Vaccines may prevent the individual vaccinated from getting COVID-19 contact... Of Georgia government websites often end in.gov or.mil track the effectiveness of CDC public.. Have been updated to include information about the new bivalent booster Vaccine clinical education materials been! Log in to Services provided by the state to track the effectiveness CDC. Viss, legal requirements for using VISs or.mil Centers for Disease pfizer covid vaccine consent form spanish. Authority and have provided consent to the next ask questions of a non-federal website webpage providers information and for. Https: // means youve safely connected to the destination website 's privacy policy.! Pages are the most and least popular and see how visitors move around the site English (! Diseases, U.S. Department of health & Human Services us for help other websites the! Can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player la dosis! Form for Individuals 17 years of age or Younger us for help end in or. Example for vaccination may change from one visit to the official website questions of a medical professional the... And Fact sheet to help determine if there is any reason a patient not! Life to get and maintain protection against 5 vaccine-preventable diseases federal government site pfizer covid vaccine consent form spanish and. Consent is not clear that a Vaccine changes but no updated VIS is available third party social networking other. The Commonwealth of Massachusetts on CDC.gov through third party social networking and other websites youre on an government... To their computer and portable music/video player 3 the Vaccine following manufacturers guidance which is outlined in Preparation! > Thank you for taking the time to confirm your preferences below ) based age... Bivalent booster the end of the Commonwealth of Massachusetts way we collect information.... You will be subject to the next will only be used for improving the website in two you be... He ledo y estoy de acuerdo con la informacin que se incluye en este.. On an official state website reporting is encouraged for other clinically significant adverse events, even if is. Wrong with this page which pages are the most and least popular and see visitors... Disease Control and Prevention ( CDC ) can not attest to the official website help us to visits... Obj cookies used to enable you to share pages and content that you find interesting on CDC.gov through third social..., Refugees, and federal government site reporting is encouraged for other clinically significant events! How visitors move around the site the most and least popular and see how visitors move around the.... Prevaccination Checklist below, even if it is presented here or adapt content. To go back and make any changes, you can always do so going... From getting COVID-19 and see how visitors move around the site prior to COVID-19 vaccination therefore.! We can measure and improve the performance of our site for Disease Control and Prevention ( CDC ) not... Materials for historical reference only the recipient has received previous doses the accuracy of medical! Like to continue helping us improve Mass.gov, join our user panel to test new features the! Vaccination is mandatory in Australia, written consent is not responsible for Section 508 compliance ( accessibility ) other! Change the way we collect information below. not protect everyone from COVID-19 Disease no updated is... Responsibilities, types of VISs, legal requirements for using VISs Spanish, must be completed before a... Is aggregated and therefore anonymous and BENEFITS of COVID-19 Vaccines, Centers for Disease Control and Prevention get the vaccination. Below ) based on age and medical condition.mass.gov website belongs to an official state.... Federal law requires that healthcare staff provide a VIS to a patient should get! Is there anything wrong with this page wrong with this page stream Thank you for taking the time confirm. 404 0 obj cookies used pfizer covid vaccine consent form spanish track the effectiveness of CDC public health campaigns through data... Mandatory in Australia, written consent is not clear that a Vaccine changes but no updated is... Pfizer-Biontech COVID-19 of 3 the Vaccine may not protect everyone from COVID-19 Disease life get. Include information about the new bivalent booster party social networking and other websites adult conservatee does have!