Date post: | 01-Jan-2016 |
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Screening Questions
1. Is your child sick today?
2. Does your child have allergies to medications, food, or any vaccine?
3. Has the child had a serious reaction to a vaccine in the past?
4. Has the child had a seizure or a brain problem?
5. Does your child have cancer, leukemia, AIDS or any other immune system problem?
Screening Questions
6. Has the child received a transfusion of blood or blood products, or been given a medicine called immune (gamma) globulin in the past year?
7. Has your child taken cortisone, prednisone, other steroids or anticancer drugs or had x-ray treatments in the past 3 months?
8. Is the child/teen pregnant or is there a chance she could become pregnant during the next month.
9. Has the child received any vaccinations in the past 4 weeks?
10. Did you bring your child’s immunization record with you?
Documentation Requirements
• Federal requirements for vaccine documentation: • Type of vaccine• Date given• Route• Manufacturer• Lot number• Administration Site • Vaccine Information Statement publication date• Name and title of person administering vaccine• Office name, address, and phone number• Any exemptions must be documented in the
patients chart
Documentation Requirements
• VFC screening is required for state supplied vaccine• Includes screening for Medicaid, Alaska Native,
American Indian, no health insurance, or underinsured
• Patient screening questions also need to be documented at each visit
• If parent does not want their children immunized, have them sign an exemption form which is located on the IRIS main page
Exemption Documentation
• Have the parent sign the exemption form for every separate antigen that the child will not be immunized for.