2023年10月13日 · The COVID-19 vaccine by Pfizer-BioNTech is an FDA-approved COVID-19 vaccine (brand name Comirnaty, mRNA) to prevent COVID-19 in persons 12 years of age and …
Have you received a previous dose of COVID-19 vaccine? The FDA has made the COVID-19 vaccine available under an emergency use authorization (EUA). The EUA is used when …
2022年11月18日 · Are you 12 years of age or older and have you received a complete COVID-19 vaccine primary series (e.g., 2 doses of Moderna, Pfizer, or Novavax vaccine, or 1 dose of …
Have you been diagnosed with or tested positive for COVID-19 in the last 14 days? In the past 14 days have you been identified as a close contact to someone with COVID-19?
Section D (Consent and Release) I understand the benefits and risks of the vaccination(s) as described in the Vaccine Information Statement (VIS), a copy of which was provided with this …
Have you been diagnosed with or tested positive for COVID-19 in the last 14 days? In the past 14 days have you been identified as a close contact to someone with COVID-19?
Recipients must receive both doses of the Pfizer-BioNTech COVID-19 Vaccine to complete vaccination. Recipient is 16 years of age or older. a diminished immune response to the Pfizer …
I reviewed this consent form and have read and understand the “Fact Sheet for Recipients and Caregivers” about the potential risks and benefits of the corresponding vaccine. I have the …
Informed Consent: Please read and sign. By my signature below, I consent to the administration of the vaccine(s) by a pharmacist or a supervised student pharmacist or technician, or other …
By signing below, I acknowledge that I understand the benefits, risks and alternatives to the COVID-19 vaccine and request and consent to be vaccinated. I further acknowledge that I …
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