预防接种证-英文.doc

Scraping the coat, input the code to inquire true and falseFor China Mobile, sending short message 9500024 to inquireShenyang Center for Disease Control and PreventionSupervised by Liaoning Anti-fake CenterNoticeVaccines uniformly provided by Shenyang Center for Diseases Control and Prevention are pasted with special supply identification, and please check in the process of vaccination. Vaccinate by the Certificate, SafekeepingThis certificate is uniformly made by Shenyang Center for Disease Control and Prevention, and is distributed for free. Shenyang Immunization RecordShenyang Center for Disease Control and Prevention Bacillus Calmette Guerin vaccine has been vaccinated, the infant shall be reviewed on the first Monday when the infant was born for 4 monthsGuide to Parents1. According to the regulations of Article XII of “Law on the Prevention and Control of Infectious Diseases of Peoples Republic of China” and “The State Implements Immunization Certificate System”, our city will uniformly use Shenyang Immunization Record. 2. Immunization record is the effective proof for children to receive vaccination according to the law. When the newborn is born, the parents or guardians shall timely apply to transact the immunization procedures to the delivery unit or immunization medial health unit. 3. For each immunization of the children, the parents or guardians shall hold this certificate to vaccinate for children in designated location, vaccination outpatient clinic, vaccination station, or village health center. 4. Children can enroll in a nursery, kindergarten, school, or going abroad by this certificate. If the children do not have this certificate or do not vaccinate according to this certificate, they must re-register this certificate and re-vaccinate, otherwise the formalities will not be transacted5. When the household registrations of the children are migrated or live in new regions away from home, the parents or guardians shall hold this certificate to transact the immigration formalities in the designated location, vaccination outpatient clinic, vaccination station, or village health center, and returning to the place original residence to transact the emigration formalities6. This certificate shall be kept well. If the certificate is damaged or lost, the parents or guardians shall apply re-issuance to the local region or or village health center. 7. After vaccination, the children may have slight fever, local pain or red and swollen, which are the normal reaction and can fade within 3 days. If there are abnormal conditions after vaccination, please timely report to the vaccination unit and go to medical unit to receive symptomatic treatment8. When the relevant departments examine the vaccination work, the parents or guardians shall show this certificate for inspection. When the infant was born for a month, two or three hepatitis B vaccines shall be injected on Tuesday or Thursday of the first week at outpatient clinic of registered residences location.Shenyang Center for Disease Control and PreventionNo.: SZ-0504Name of Child: Qianhao Yu Sex: Male Date of Birth: March 15, 2005 Weight of Birth: 3,500g Address: Residence Address: County / District Street / VillagePlace of Work / School Tel: Juveniles who are under the age of 16 should fill the following informationParents name: father: Zhiqun Yu Mother: Jing LuWorking Unit: Farther Mother Telephone No.: Farther Mother Date of removal: Year Month Day Address of removal County / DistrictWhether insurance or not Date of issue: March 25, 2005 The issuing Authority (Seal): Shenyang Huanggu Central Hospital Vaccination Public BoardName of vaccinesDiseases that can preventsVaccinated populationPrice of vaccinationBacillus Calmette Guerin vaccineTuberculosisNewbornFreeHepatitis B vaccine（5ug)Hepatitis BNewborn 0, 1 and 6 monthsFreePoliomyelitis vaccinePoliomyelitis2, 3, 4 months, 1.5 2 years old, 4 years oldFreeMeasles Attenuated Live VaccineMeasles8 months, 1.5-2 years old, 6 years oldFreePertussis-Diphtheria-Tetanus triple vaccinePertussis, diphtheria, tetanus3, 4, 5months, 1.5-2 years oldFree, acellular pertussis diphtheria tetanus vaccine shall be paid.Tetanus-diphtheria Combined VaccineDiphtheria, tetanus6 years oldFreeEpidemic encephalitis B vaccineEpidemic encephalitis B2 vaccinations at early period of 6 months - 1.5 years old are no need; separately intensify once at 2 years old and 6 years oldFree, but Vero cells epidemic encephalitis B shall be paid.Group A Meningococcal polysaccharide vaccineEpidemic cerebrospinal meningitis (Group A)Separately vaccinate once at 1, 2, 4 and 6 years oldFreeGroup A+C Meningococcal polysaccharide vaccineEpidemic cerebrospinal meningitis (Group A+C)Above 2 years oldSelf-pay (including insurance)Hepatitis B vaccine（10ug)Hepatitis BAll the populationSelf-payHepatitis B hyper-immune globulinHepatitis BNewborn, accidentally infected population, pregnant of hepatitis B virus carrierSelf-payHepatitis A vaccineHepatitis AAbove 1 years old Self-payLive Attenuated Varicella vaccineVaricella, herpes zosterAdult / 6-13 years old / 2-5 years old childrenSelf-payHaemophilus Influenzae type B vaccineChildren pneumonia, meningitis caused by Haemophilus Influenzae type B, etc.2 months - 5 years oldSelf-pay23-valent pneumococcal polysaccharide vaccinePneumonia, meningitis, otitis media, etc. caused by pneumococcusVaccinate 3 times for 6 months old (2 months, 3 months and 4 months); vaccinate 2 times for 6 months old - 1 year old; vaccinate once for 1 year old to 5 years oldSelf-payVaccine by lysis of influenza virusInfluenza, etc. caused by influenza virus Vaccinate once at 5 years oldSelf-payInfluenza vaccine cleavage vaccineMeasles, rubella, mumpsAbove 2 years oldSelf-payMeasles and rubella bivalent vaccineMeasles, rubellaAbove 6 months oldSelf-payMeasles, mumps bivalent vaccineMeasles, mumpsAbove 1 years oldSelf-payAttenuated live rubella vaccineRubellaAbove 1 years oldSelf-payBivalent live vaccine capsule of dysenteryBacillary dysenteryAbove 8 months oldSelf-payLive oral rotavirus vaccineInfantile rotavirus diarrheaAbove 1 years oldSelf-payNotes: The charge vaccines uniformly distributed by Shenyang Center for Disease Control and Prevention are pasted with uniform mark, persons who are vaccinated should pay attention to check.The injection cost is RMB 2.0 (LJF (2003) No. 35), and RMB 0.9 will be collected for self-destruction syringe if needed. Informed Consent Form for Vaccination Program Immune VaccineCategory of VaccinesContraindicationReactionHepatitis B vaccinePersons who suffer from hepatitis, fever, acute or chronic disease, serious skin eczema, preterm low body weight, serious viscera deformity and allergic history are forbidden to use this vaccine.Slight reaction, a few people will have blush and induration in the position of vaccine injection, and will fade away in 2-3 days. There is generally no whole body reaction, and very few persons will appear chilly or low fever, and individual is reported to have urticarial. Poliomyelitis vaccine1. Persons who have immunodeficiency or are in the period of accepting the therapy of immunosuppressant is forbidden to get vaccinated. 2. Persons who are allergic to milk or milk products are forbidden to get vaccinated.3. Persons who have fever or diarrhea (defecate more than 4 times a day) or suffer from acute infectious disease is forbidden to get vaccinated. Only very few infants will have transient diarrhea after being vaccinated, and will self-cure. Measles vaccinePersons who have serious diseases, fever or allergic history (especially who are allergic to eggs) are forbidden to get vaccinated. There is no reaction in partial body after rejection. A few persons may have fever, and generally will not exceed 2 days, and someone will have sporadic rash.Pertussis-diphtheria-tetanus triple vaccine1. Persons who have epilepsy, nervous system disease or convulsions history are forbidden to get vaccinated.2. Persons who have acute infectious disease (including rehabilitation stage) or fever are postponed to get vaccinated. 1. Local part may appear red, pain and tickle or low fever, fatigue, headache, etc. Generally, there is no need of special treatments, and the symptoms will fade spontaneously. 2. Aseptic suppuration3. If reaction of the whole body is severe, the persons who get vaccinated shall go to hospital for diagnosis and treatment. 4. Diphtheria, tetanus and acellular pertussis combined vaccine: the whole body reaction or local reaction is very slight.Epidemic meningitis vaccine1. Persons who have nervous system disease and mental disease are forbidden to get vaccinated. 2. Persons who have serious disease, such as kidney disease, heart disease, active tuberculosis, etc. are forbidden to get vaccinated.3. Persons who have acute infectious disease and fever are forbidden to get vaccinated.After rejection, the reaction is alight, and a few people have short-time fever, which often happens at 6 8 hours after vaccination. Local is flush and the pressure pain, and will gradually fade after vaccinationEpidemic encephalitis B vaccinePersons who have fever, acute infectious disease, otitis media, heart, kidney, liver disease, active tuberculosis, allergic history or convulsions history are forbidden to get vaccinated; persons who have compromised immune system or are accepting immunosuppressive therapy are forbidden to get vaccinated. After rejection, generally there is no reaction, and a very few persons will have local flush, sometimes have fever, rash, allergic shock, angioedema, etc. Informed Consent Form for Vaccination Program Immune Vaccine (1)1. HIB: hemophilus influenzae B conjugate vaccine 2. Hepatitis A vaccinePreventable diseases: infectious diseases caused by hemophilus influenzae B (meningitis, pneumonia, septicemia, phlegmon, arthritis, epiglottitis, etc.)Preventable diseases: Hepatitis AContraindication1. Allergic people who are known to be allergic with some content of the vaccine, especially to tetanus toxoid, or allergic with inoculation of previous vaccine.2. The inoculation shall be delayed during active stage of fever or acute diseases, especially infectious diseases or chronic diseases.3. Normal reactions of immunization that can be reduced by immunosuppressive therapy and immunodeficiency.Hepatitis A inactivationHepatitis A attenuationContraindication1. Patients who have Hepatitis and other serious diseases.2. Patients of febrile diseases shall delay the inoculation. 3. People who are known to be allergy for any content of the vaccine.1. People who are not feeling good and the body temperature is over 37.5 .2. People who have acute infectious disease or other serious diseases.3. People who suffer from idiopathic and acquired immune deficiency.4. People who are receiving immunosuppressive therapy.5. Pregnant women and people of allergic constitution.Possible reactions after inoculation1. Partial reactions of injection positions: pain, rubefaction or inflammation. In general, this partial reaction is early-stage, transient and slight, and sometimes atypical rash can be observed.2. Extremely unusual cases may appear edema of lower extremity, along with cyanosis or transient purpura. This reaction usually appears within the first few hours after inoculation, and usually quickly disappears spontaneously without any sequela; there are usually no symptoms of disease and respiratory system, and this occasion often appears during simultaneous inoculation with other vaccines.3. Unusual allergy reaction cases may appear in face or throat; rubella alike rash, pruritus and edema.4. Systematic symptoms: fever (usually lower than 39), and enhanced excitability and crying appear more often. Possible reactions after inoculation1. Partial side reactions are usually pain, and sometimes red & swollen, and indurate.2. Systematic side reactions include headache, fever, nausea, etc. The duration is usually less than 24 hours, and can relieve by self.3. The expectant treatment shall be made in time for allergy reaction.No partial or systematic untoward effect after inoculation of Hepatitis A attenuation inactivation vaccine.Protective effect95%Signature of visiting doctor: Date: Signature of visiting doctor: Date:Signature of parent (s): Date: Signature of parent (s): Date:Informed Consent Form for Vaccination Program Immune Vaccine (2)3. MMR vaccine 4. Chicken pox attenuation and inactivation vaccinePreventable diseases: measles, mumps, rubella.Preventable diseases: water mark herpes zoster.ContraindicationPeople who have serious diseases, acute and chronic infection, fever or allergic history with eggs shall not inoculate.Pregnant women are forbidden to use, fertile women who inoculate shall avoid pregnancy within 3 months after inoculation.DomesticImportedContraindication1. People who have serious diseases and fever shall delay the inoculation.2. People who have allergy history and pregnant women shall be forbidden to use.3. Patients of leukemia, tumor, immunodeficiency, etc. shall use with caution under doctors guidance.1. Same with other vaccine, people who have acute serious fever diseases shall delay the inoculation, however, for healthy people, slight infection is not immune contraindication.2. People whose total lymphocyte is less than 1200 / mm3 or proved to lack cellular immune function shall be forbidden to use.3. People who are known as hypersensitive with neomycin shall be forbidden to use, but people who have contact dermatitis with neomycin are not included in the contraindication.4. Forbidden to use in pregnancy duration.Possible reactions after inoculation1. Within 6 to 11 days, few children may appear transient fever reaction or slight rash which will automatically relieve less than 2 days.2. Adult women occasionally appear slight arthralgia, and need no special treatment normally. Expectant treatment can be made when necessary.Possible reactions after inoculation1. Usually no side reaction after injection, occasionally with slight partial reaction.2. Rarely seen slight or medium fever, transient eruption for less than 3 days. Expectant treatment can be made when necessary.1. Healthy people: comprehensive reactogenicity of all the age groups are quite low, and the reactions of injection position are usually slight and temporary.2. High risk patients: the reactions of injection position are usually slight; Papule vesiculobullous rash may appear within several days or weeks after immune treatment, rarely with slight to medium fever, and only less than 1/4 leukemia patients have these reactions. These rashes are usually slight and short.Protective effectMeasles 99% Rubella 99% Mumps 85%Protective effect99%Childrens Planned Immunization Program Immunization AppointmentVaccinesDate of AppointmentVaccineDate of AppointmentVaccineAGEBCGHBVOPVDPTMVEncephalitisMeningo-coccus A Vaccine0monthBaseBaseMarch 31, 2015HBIG1monthBaseNovember 13, 2007Morning, influenza vaccine2monthBase3 years influenza vaccine3monthBaseBase4monthBaseBaseTuesday Morning5monthBase6monthBaseBase Second7month8month9month1year1.5yearsBoosterBoosterBooster2yearsBoosterBooster4yearsBoosterBoosterPlease check if your child has completed the immunization as scheduled6yearsBoosterDTBoosterBoosterBooster Birth Date: March 15, 2005Immunization Appointment Immunization Record (I)Date of AppointmentVaccineDate of AppointmentVaccineVaccinesDate of Immunization Lot Number of VaccineUnit of ImmunizationSignatureBCGPrimaryimmMarch 15, 2005200406047-1202+PPDJuly 21, 20051212202+HBIGFirstMarch 15, 200520040802Lina ZhaoSecondHeping District Tuberc