The Immunization Record form is a vital document that tracks an individual's vaccination history. It serves as proof of immunization, which is essential for school and child care enrollment in California. Parents should retain this record carefully, as it contains important information regarding their child's health and compliance with immunization requirements.
The Immunization Record form is a crucial document for parents and guardians, particularly in California, where it serves as proof of a child's immunization status required for school and childcare enrollment. This form includes essential information such as the child's name, birthdate, and sex, along with a section for allergies and vaccine reactions. Each vaccine administered is recorded, detailing the date given, the next due dose, and the name of the healthcare provider or clinic. The form lists various vaccines, including those for diseases such as diphtheria, tetanus, pertussis, hepatitis, and influenza, among others. It also provides space for tuberculosis skin tests, including interpretation notes and the necessary follow-up actions if a test result is positive. Parents are advised to retain this document for future reference, as it plays a vital role in ensuring that children meet the immunization requirements set forth by health authorities. Understanding the details on this form can help ensure that children remain compliant with necessary health regulations while promoting their overall well-being.
Passport Renewal Checklist - Child passports should have been issued after July 1, 2005, for eligible renewal requests.
Make Insurance Card - Record the name and address of witnesses in case of accidents.
Understanding the Immunization Record form is crucial for parents and guardians. However, several misconceptions exist about this important document. Here are seven common misunderstandings:
Many people believe that vaccinations are a personal choice and not mandatory. In California, however, children must meet specific immunization requirements to enroll in school and child care.
Some individuals think that once a child is vaccinated, the record is no longer needed. In reality, this document serves as proof of immunization and may be required for school enrollment or other activities.
While the form includes many common vaccines, it may not list every vaccine available. Parents should consult healthcare providers for a complete understanding of the immunizations their child may need.
This form includes information in both English and Spanish, making it accessible to a broader audience. Understanding the content in one's preferred language is essential for proper compliance.
Some parents think the Immunization Record is static. In fact, it can and should be updated as new vaccinations are administered, ensuring that the record remains current.
While the form primarily targets children, adults also need to maintain their immunization records for various reasons, including travel and employment requirements.
There is a common belief that vaccines lead to serious reactions. Most vaccine side effects are mild and temporary. Serious side effects are rare, and the benefits of vaccination generally outweigh the risks.
By clarifying these misconceptions, parents can better navigate the immunization process and ensure their children receive the necessary vaccinations for a healthy future.
1. Keep the Immunization Record Safe: This document serves as proof of your child's immunizations. It is essential to retain it, as you will need it for school and child care enrollment.
2. Understand Immunization Requirements: In California, your child must meet specific immunization requirements to attend school and child care. Familiarize yourself with these requirements to ensure compliance.
3. Fill Out the Form Accurately: When completing the Immunization Record, provide accurate details about your child's name, birthdate, and any allergies. Ensure that vaccine dates and doses are correctly noted by the healthcare provider.
4. Be Aware of Vaccine Types: The form lists various vaccines, such as DTaP, MMR, and HPV. Understanding these vaccines and their purposes can help you keep track of your child's immunization schedule effectively.
When filling out the Immunization Record form, it is essential to ensure accuracy and completeness. Here are five things you should and shouldn't do:
By following these guidelines, you can help ensure that your child's immunization record is properly documented and accepted by schools and child care facilities.
IMMUNIZATION RECORD
Comprobante de Inmunización
Name nombre
Birthdate
Sex
fecha de nacimiento
sexo
Allergies
alergias
Vaccine Reactions
reacciones a la vacuna
RETAIN THIS DOCUMENT — CONSERVE ESTE DOCUMENTO
DATE
NEXT
GIVEN
DOSE DUE
VACCINE
fecha de
DOCTOR OFFICE OR CLINIC
próxima
vacuna
vacunación
médico o clínica
Parents: Your child must meet California’s immunization requirements to be enrolled in school and child care. Keep this Record as proof of immunization.
Padres: Su niño debe cumplir con los requisitos de vacunas para asistir a la escuela y a la guardería. Mantenga este Comprobante: lo necesitará.
DT/Td = Diphtheria, tetanus
[difteria, tétano]
DTaP/Tdap = Diphtheria, tetanus, and pertussis (whooping cough)
[difteria, tétano, y tos ferina]
DTP = Diphtheria, tetanus, pertussis (whooping cough)
HEP A = Hepatitis A
HEP B = Hepatitis B
HIB = Hib meningitis (
Haemophilus influenzae
type b)
[meningitis Hib]
HPV = Human papillomavirus
[virus del papiloma humano]
INFV = Influenza [la gripe]
MCV = Meningococcal conjugate vaccine [vacuna meningocócia conjugada]
MMR = Measles, mumps, rubella [sarampión, paperas y rubéola (sarampión alemán)]
MPV = Meningococcal polysaccharide vaccine
[vacuna meningocócia polisacárida]
PNEUMO = Pneumococcal vaccine [neumocócica]
POLIO = Poliomyelitis
[poliomielitis]
RV = Rotavirus [rotavirus]
VZV = Varicella (chickenpox)
[varicela]
Registry ID Number
TB SKIN TESTS*
Pruebas de la Tuberculosis
Type**
Date given
Given by
Date read
Read by
mm/indur
Impression
* A chest x-ray may be indicated if skin test is positive.
** If required for school entry, must be Mantoux unless exception granted by local health department.
CHEST X-RAY
Film date: ____/____/____
Interpretation:
normal
abnormal
[Radiografiá]
Person is free of communicable tuberculosis
yes
no
(Necessary if skin test positive.)
Signature/Agency: __________________________________________________
PM 298 F2 (8/08) IMM-75LK