预防接种证英文

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ShenyangCenterforDiseaseControlandPrevention

SupervisedbyLiaoningAnti-fakeCenter

Notice

VaccinesuniformlyprovidedbyShenyangCenterforDiseasesControlandPreventionarepastedwithspecialsupplyidentification,andpleasecheckintheprocessofvaccination.

VaccinatebytheCertificate,Safekeeping

ThiscertificateisuniformlymadebyShenyangCenterforDiseaseControlandPrevention,andisdistributedforfree.

ShenyangImmunizationRecord

ShenyangCenterforDiseaseControlandPrevention

BacillusCalmetteGuerinvaccinehasbeenvaccinated,theinfantshallbereviewedonthefirstMondaywhentheinfantwasbornfor4months

GuidetoParents

AccordingtotheregulationsofArticleXIIof“LawonthePreventionandControlofInfectiousDiseasesofPeople’sRepublicofChina”and“TheStateImplementsImmunizationCertificateSystem”,ourcitywilluniformlyuseShenyangImmunizationRecord.

Immunizationrecordistheeffectiveproofforchildrentoreceivevaccinationaccordingtothelaw.Whenthenewbornisborn,theparentsorguardiansshalltimelyapplytotransacttheimmunizationprocedurestothedeliveryunitorimmunizationmedialhealthunit.

Foreachimmunizationofthechildren,theparentsorguardiansshallholdthiscertificatetovaccinateforchildrenindesignatedlocation,vaccinationoutpatientclinic,vaccinationstation,orvillagehealthcenter.

Childrencanenrollinanursery,kindergarten,school,orgoingabroadbythiscertificate.Ifthechildrendonothavethiscertificateordonotvaccinateaccordingtothiscertificate,theymustre-registerthiscertificateandre-vaccinate,otherwisetheformalitieswillnotbetransacted

Whenthehouseholdregistrationsofthechildrenaremigratedorliveinnewregionsawayfromhome,theparentsorguardiansshallholdthiscertificatetotransacttheimmigrationformalitiesinthedesignatedlocation,vaccinationoutpatientclinic,vaccinationstation,orvillagehealthcenter,andreturningtotheplaceoriginalresidencetotransacttheemigrationformalities

Thiscertificateshallbekeptwell.Ifthecertificateisdamagedorlost,theparentsorguardiansshallapplyre-issuancetothelocalregionororvillagehealthcenter.

Aftervaccination,thechildrenmayhaveslightfever,localpainorredandswollen,whicharethenormalreactionandcanfadewithin3days.Ifthereareabnormalconditionsaftervaccination,pleasetimelyreporttothevaccinationunitandgotomedicalunittoreceivesymptomatictreatment

Whentherelevantdepartmentsexaminethevaccinationwork,theparentsorguardiansshallshowthiscertificateforinspection.

Whentheinfantwasbornforamonth,twoorthreehepatitisBvaccinesshallbeinjectedonTuesdayorThursdayofthefirstweekatoutpatientclinicofregisteredresidence’slocation.

ShenyangCenterforDiseaseControlandPrevention

No.:SZ-0504

NameofChild:QianhaoYuSex:Male

DateofBirth:March15,WeightofBirth:3,500g

Address:

ResidenceAddress:County/DistrictStreet/Village

PlaceofWork/SchoolTel:

Juvenileswhoareundertheageof16shouldfillthefollowinginformation

Parents’name:father:ZhiqunYuMother:JingLu

WorkingUnit:FartherMother

TelephoneNo.:FartherMother

Dateofremoval:YearMonthDay

AddressofremovalCounty/District

Whetherinsuranceornot

Dateofissue:March25,

TheissuingAuthority(Seal):ShenyangHuangguCentralHospital

VaccinationPublicBoard

Nameofvaccines

Diseasesthatcanprevents

Vaccinatedpopulation

Priceofvaccination

BacillusCalmetteGuerinvaccine

Tuberculosis

Newborn

Free

HepatitisBvaccine（5ug)

HepatitisB

Newborn0,1and6months

Free

Poliomyelitisvaccine

Poliomyelitis

2,3,4months,1.5–2yearsold,4yearsold

Free

MeaslesAttenuatedLiveVaccine

Measles

8months,1.5-2yearsold,6yearsold

Free

Pertussis-Diphtheria-Tetanustriplevaccine

Pertussis,diphtheria,tetanus

3,4,5months,1.5-2yearsold

Free,acellularpertussisdiphtheriatetanusvaccineshallbepaid.

Tetanus-diphtheriaCombinedVaccine

Diphtheria,tetanus

6yearsold

Free

EpidemicencephalitisBvaccine

EpidemicencephalitisB

2vaccinationsatearlyperiodof6months-1.5yearsoldarenoneed;separatelyintensifyonceat2yearsoldand6yearsold

Free,butVerocellsepidemicencephalitisBshallbepaid.

GroupAMeningococcalpolysaccharidevaccine

Epidemiccerebrospinalmeningitis(GroupA)

Separatelyvaccinateonceat1,2,4and6yearsold

Free

GroupA+CMeningococcalpolysaccharidevaccine

Epidemiccerebrospinalmeningitis(GroupA+C)

Above2yearsold

Self-pay(includinginsurance)

HepatitisBvaccine（10ug)

HepatitisB

Allthepopulation

Self-pay

HepatitisBhyper-immuneglobulin

HepatitisB

Newborn,accidentallyinfectedpopulation,pregnantofhepatitisBviruscarrier

Self-pay

HepatitisAvaccine

HepatitisA

Above1yearsold

Self-pay

LiveAttenuatedVaricellavaccine

Varicella,herpeszoster

Adult/6-13yearsold/2-5yearsoldchildren

Self-pay

HaemophilusInfluenzaetypeBvaccine

Childrenpneumonia,meningitiscausedbyHaemophilusInfluenzaetypeB,etc.

2months-5yearsold

Self-pay

23-valentpneumococcalpolysaccharidevaccine

Pneumonia,meningitis,otitismedia,etc.causedbypneumococcus

Vaccinate3timesfor6monthsold(2months,3monthsand4months);vaccinate2timesfor6monthsold-1yearold;vaccinateoncefor1yearoldto5yearsold

Self-pay

Vaccinebylysisofinfluenzavirus

Influenza,etc.causedbyinfluenzavirus

Vaccinateonceat5yearsold

Self-pay

Influenzavaccinecleavagevaccine

Measles,rubella,mumps

Above2yearsold

Self-pay

Measlesandrubellabivalentvaccine

Measles,rubella

Above6monthsold

Self-pay

Measles,mumpsbivalentvaccine

Measles,mumps

Above1yearsold

Self-pay

Attenuatedliverubellavaccine

Rubella

Above1yearsold

Self-pay

Bivalentlivevaccinecapsuleofdysentery

Bacillarydysentery

Above8monthsold

Self-pay

Liveoralrotavirusvaccine

Infantilerotavirusdiarrhea

Above1yearsold

Self-pay

Notes:ThechargevaccinesuniformlydistributedbyShenyangCenterforDiseaseControlandPreventionarepastedwithuniformmark,personswhoarevaccinatedshouldpayattentiontocheck.

TheinjectioncostisRMB2.0(LJF()No.35),andRMB0.9willbecollectedforself-destructionsyringeifneeded.

InformedConsentFormforVaccinationProgramImmuneVaccine

CategoryofVaccines

Contraindication

Reaction

HepatitisBvaccine

Personswhosufferfromhepatitis,fever,acuteorchronicdisease,seriousskineczema,pretermlowbodyweight,seriousvisceradeformityandallergichistoryareforbiddentousethisvaccine.

Slightreaction,afewpeoplewillhaveblushandindurationinthepositionofvaccineinjection,andwillfadeawayin2-3days.Thereisgenerallynowholebodyreaction,andveryfewpersonswillappearchillyorlowfever,andindividualisreportedtohaveurticarial.

Poliomyelitisvaccine

1.Personswhohaveimmunodeficiencyorareintheperiodofacceptingthetherapyofimmunosuppressantisforbiddentogetvaccinated.

2.Personswhoareallergictomilkormilkproductsareforbiddentogetvaccinated.

3.Personswhohavefeverordiarrhea(defecatemorethan4timesaday)orsufferfromacuteinfectiousdiseaseisforbiddentogetvaccinated.

Onlyveryfewinfantswillhavetransientdiarrheaafterbeingvaccinated,andwillself-cure.

Measlesvaccine

Personswhohaveseriousdiseases,feverorallergichistory(especiallywhoareallergictoeggs)areforbiddentogetvaccinated.

Thereisnoreactioninpartialbodyafterrejection.Afewpersonsmayhavefever,andgenerallywillnotexceed2days,andsomeonewillhavesporadicrash.

Pertussis-diphtheria-tetanustriplevaccine

1.Personswhohaveepilepsy,nervoussystemdiseaseorconvulsionshistoryareforbiddentogetvaccinated.

2.Personswhohaveacuteinfectiousdisease(includingrehabilitationstage)orfeverarepostponedtogetvaccinated.

1.Localpartmayappearred,painandtickleorlowfever,fatigue,headache,etc.Generally,thereisnoneedofspecialtreatments,andthesymptomswillfadespontaneously.

2.Asepticsuppuration

3.Ifreactionofthewholebodyissevere,thepersonswhogetvaccinatedshallgotohospitalfordiagnosisandtreatment.

4.Diphtheria,tetanusandacellularpertussiscombinedvaccine:thewholebodyreactionorlocalreactionisveryslight.

Epidemicmeningitisvaccine

1.Personswhohavenervoussystemdiseaseandmentaldiseaseareforbiddentogetvaccinated.

2.Personswhohaveseriousdisease,suchaskidneydisease,heartdisease,activetuberculosis,etc.areforbiddentogetvaccinated.

3.Personswhohaveacuteinfectiousdiseaseandfeverareforbiddentogetvaccinated.

Afterrejection,thereactionisalight,andafewpeoplehaveshort-timefever,whichoftenhappensat6–8hoursaftervaccination.Localisflushandthepressurepain,andwillgraduallyfadeaftervaccination

EpidemicencephalitisBvaccine

Personswhohavefever,acuteinfectiousdisease,otitismedia,heart,kidney,liverdisease,activetuberculosis,allergichistoryorconvulsionshistoryareforbiddentogetvaccinated;personswhohavecompromisedimmunesystemorareacceptingimmunosuppressivetherapyareforbiddentogetvaccinated.

Afterrejection,generallythereisnoreaction,andaveryfewpersonswillhavelocalflush,sometimeshavefever,rash,allergicshock,angioedema,etc.

InformedConsentFormforVaccinationProgramImmuneVaccine(1)

1.HIB:hemophilusinfluenzaeBconjugatevaccine2.HepatitisAvaccine

Preventablediseases:infectiousdiseasescausedbyhemophilusinfluenzaeB(meningitis,pneumonia,septicemia,phlegmon,arthritis,epiglottitis,etc.)

Preventablediseases:HepatitisA

Contraindication

1.Allergicpeoplewhoareknowntobeallergicwithsomecontentofthevaccine,especiallytotetanustoxoid,orallergicwithinoculationofpreviousvaccine.

2.Theinoculationshallbedelayedduringactivestageoffeveroracutediseases,especiallyinfectiousdiseasesorchronicdiseases.

3.Normalreactionsofimmunizationthatcanbereducedbyimmunosuppressivetherapyandimmunodeficiency.

HepatitisAinactivation

HepatitisAattenuation

Contraindication

1.PatientswhohaveHepatitisandotherseriousdiseases.

2.Patientsoffebrilediseasesshalldelaytheinoculation.

3.Peoplewhoareknowntobeallergyforanycontentofthevaccine.

1.Peoplewhoarenotfeelinggoodandthebodytemperatureisover37.5℃.

2.Peoplewhohaveacuteinfectiousdiseaseorotherseriousdiseases.

3.Peoplewhosufferfromidiopathicandacquiredimmunedeficiency.

4.Peoplewhoarereceivingimmunosuppressivetherapy.

5.Pregnantwomenandpeopleofallergicconstitution.

Possiblereactionsafterinoculation

1.Partialreactionsofinjectionpositions:pain,rubefactionorinflammation.Ingeneral,thispartialreactionisearly-stage,transientandslight,andsometimesatypicalrashcanbeobserved.

2.Extremelyunusualcasesmayappearedemaoflowerextremity,alongwithcyanosisortransientpurpura.Thisreactionusuallyappearswithinthefirstfewhoursafterinoculation,andusuallyquicklydisappearsspontaneouslywithoutanysequela;thereareusuallynosymptomsofdiseaseandrespiratorysystem,andthisoccasionoftenappearsduringsimultaneousinoculationwithothervaccines.

3.Unusualallergyreactioncasesmayappearinfaceorthroat;rubellaalikerash,pruritusandedema.

4.Systematicsymptoms:fever(usuallylowerthan39℃),andenhancedexcitabilityandcryingappearmoreoften.

Possiblereactionsafterinoculation

1.Partialsidereactionsareusuallypain,andsometimesred&swollen,andindurate.

2.Systematicsidereactionsincludeheadache,fever,nausea,etc.Thedurationisusuallylessthan24hours,andcanrelievebyself.

3.Theexpectanttreatmentshallbemadeintimeforallergyreaction.

NopartialorsystematicuntowardeffectafterinoculationofHepatitisAattenuationinactivationvaccine.

Protectiveeffect

95%

Signatureofvisitingdoctor:Date:Signatureofvisitingdoctor:Date:

Signatureofparent(s):Date:Signatureofparent(s):Date:

InformedConsentFormforVaccinationProgramImmuneVaccine(2)

3.MMRvaccine4.Chickenpoxattenuationandinactivationvaccine

Preventablediseases:measles,mumps,rubella.

Preventablediseases:watermark–herpeszoster.

Contraindication

Peoplewhohaveseriousdiseases,acuteandchronicinfection,feverorallergichistorywitheggsshallnotinoculate.

Pregnantwomenareforbiddentouse,fertilewomenwhoinoculateshallavoidpregnancywithin3monthsafterinoculation.

Domestic

Imported

Contraindication

1.Peoplewhohaveseriousdiseasesandfevershalldelaytheinoculation.

2.Peoplewhohaveallergyhistoryandpregnantwomenshallbeforbiddentouse.

3.Patientsofleukemia,tumor,immunodeficiency,etc.shallusewithcautionunderdoctor’sguidance.

1.Samewithothervaccine,peoplewhohaveacuteseriousfeverdiseasesshalldelaytheinoculation,however,forhealthypeople,slightinfectionisnotimmunecontraindication.

2.Peoplewhosetotallymphocyteislessthan1200/mm3orprovedtolackcellularimmunefunctionshallbeforbiddentouse.

3.Peoplewhoareknownashypersensitivewithneomycinshallbeforbiddentouse,butpeoplewhohavecontactdermatitiswithneomycinarenotincludedinthecontraindication.

4.Forbiddentouseinpregnancyduration.

Possiblereactionsafterinoculation

1.Within6to11days,fewchildrenmayappeartransientfeverreactionorslightrashwhichwillautomaticallyrelievelessthan2days.

2.Adultwomenoccasionallyappearslightarthralgia,andneednospecialtreatmentnormally.Expectanttreatmentcanbemadewhennecessary.

Possiblereactionsafterinoculation

1.Usuallynosidereactionafterinjection,occasionallywithslightpartialreaction.

2.Rarelyseenslightormediumfever,transienteruptionforlessthan3days.Expectanttreatmentcanbemadewhennecessary.

1.Healthypeople:comprehensivereactogenicityofalltheagegroupsarequitelow,andthereactionsofinjectionpositionareusuallyslightandtemporary.

2.Highriskpatients:thereactionsofinjectionpositionareusuallyslight;Papulevesiculobullousrashmayappearwithinseveraldaysorweeksafterimmunetreatment,rarelywithslighttomediumfever,andonlylessthan1/4leukemiapatientshavethesereactions.Theserashesareusuallyslightandshort.

Protectiveeffect

Measles99%Rubella99%Mumps85%

Protectiveeffect

99%

Children’sPlannedImmunizationProgramImmunizationAppointment

Vaccines

DateofAppointment

Vaccine

DateofAppointment

Vaccine

AGE

BCG

HBV

OPV

DPT

MV

Encephalitis

Meningo-coccusAVaccine

0month

Base

Base①

March31,

HBIG

1month

Base②

November13,

Morning,influenzavaccine

2month

Base①

3yearsinfluenzavaccine

3month

Base②

Base①

4month

Base③

Base②

TuesdayMorning

5month

Base③

6month

Base③

BaseSecond

7month

8month

9month

1year

1.5years

Booster

Booster

Booster

2years

Booster

Booster

4years

Booster

Booster

Pleasecheckifyourchildhascompletedtheimmunizationasscheduled

6years

Booster

DT

Booster

Booster

Booster

BirthDate:March15,

ImmunizationAppointmentImmunizationRecord(I)

DateofAppointment

Vaccine

DateofAppointment

Vaccine

Vaccines

DateofImmunization

LotNumberofVaccine

UnitofImmunization

Signature

BCG

Primaryimm

March15,

-1

202+

PPD

July21,

12×12

202+

HBIG

First

March15,

0802

LinaZhao

Second

HepingDistrictTuberculosisControl

202+

HBV

Base

March15,

0649

April15,

Gao

September15,

902-2

Yuan

Gao

OPV

Base

May17,

June27,

Gao

September28,

Yuan

Booster

July14,

0906

DistrictCenter

Yuan

Pleasecheckifyourchildhascompletedtheimmunizationasscheduled

ImmunizationRecord(II)ImmunizationRecord(III)

Vaccines

DateofImmunization

LotNumberofVaccine

UnitofImmunization

Signature

Vaccines

DateofImmunization

LotNumberofVaccine

UnitofImmunization

Signature

DPT

Base

June27,

Gao

Meningococcus

AVaccine

1

March16,

06

1402

July28,

Yuan

2

June29,

06

2903

August30,

Yuan

3

July27,

090910

Booster

October8,

Yuan

4

July30,

DP

Booster

August18,

YC37B045AA

Gao

RubellaVaccine

MV

Base

November25,

Yuan

MMR

August1,

Booster

August1

MM

EncephalitisBVaccine

Base

April18,

11

2501

Yuan

MR

April27,

11

2501

Chen

VaricellaVaccine

June14,

Booster

May24,

06110301

Yuan

June16,

0106-1

DistrictCenter

Gao

PneumococcalVaccine

ImmunizationRecord(IV)ImmunizationRecord(V)

Vaccines

DateofImmunization

LotNumber

OfVaccines

Unitof

Immunization