预防接种证-英文

预防接种证-英文 Shenyang Immunization Scraping the coat, input the code to inquire true and false Notice For China Mobile, sending short Record message 9500024 to inquire Shenyang Center for Disease Control and Prevention Supervised by Liaoning Anti-fake Center Vaccines 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, Safekeeping This certificate is uniformly made by Shenyang Shenyang Center for Disease Control Center for Disease Control and Prevention, and is and Prevention distributed for free. Bacillus Calmette Guerin vaccine has been vaccinated, the infant shall be reviewed on the first Monday when the infant was born for 4 months Guide to Parents 1. According to the regulations of Article XII of “Law on the Prevention and Control of Infectious Diseases of People’s No.: SZ-0504 Republic of China” and “The State Implements Immunization Certificate System”, our city will uniformly use Shenyang Name of Child: Qianhao Yu Sex: Male Immunization Record. 2. Immunization record is the effective proof for children to Date of Birth: March 15, 2005 Weight of Birth: 3,500g 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 Address: medial health unit. 3. For each immunization of the children, the parents or guardians Residence Address: County / District Street / Village shall hold this certificate to vaccinate for children in designated location, vaccination outpatient clinic, vaccination station, or Place of Work / School Tel: 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 Juveniles who are under the age of 16 should fill the following information certificate or do not vaccinate according to this certificate, they must re-register this certificate and re-vaccinate, otherwise the Parents’ name: father: Zhiqun Yu Mother: Jing Lu formalities will not be transacted 5. When the household registrations of the children are migrated Working Unit: Farther Mother 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 Telephone No.: Farther Mother clinic, vaccination station, or village health center, and returning to the place original residence to transact the Date of removal: Year Month Day emigration formalities 6. This certificate shall be kept well. If the certificate is damaged or lost, the parents or guardians shall apply re-issuance to the Address of removal County / District local region or or village health center. 7. After vaccination, the children may have slight fever, local pain Whether insurance or not or red and swollen, which are the normal reaction and can fade within 3 days. If there are abnormal conditions after Date of issue: March 25, 2005 vaccination, please timely report to the vaccination unit and go to medical unit to receive symptomatic treatment 8. When the relevant departments examine the vaccination work, The issuing Authority (Seal): Shenyang Huanggu Central Hospital the parents or guardians shall show this certificate for inspection. When the infant was born for a month, two or Shenyang Center for Disease Control and Prevention three hepatitis B vaccines shall be injected on Tuesday or Thursday of the first week at outpatient clinic of registered residence’s location. Vaccination Public Board Diseases that can Name of vaccines Vaccinated population Price of vaccination prevents Bacillus Calmette Guerin vaccine Tuberculosis Newborn Free Free Hepatitis B vaccine(5ug) Hepatitis B Newborn 0, 1 and 6 months Free2, 3, 4 months, 1.5 – 2 years old, Poliomyelitis vaccine Poliomyelitis 4 years old Free8 months, 1.5-2 years old, 6 Measles Attenuated Live Vaccine Measles years old Pertussis, diphtheria, Free, acellular pertussis Pertussis-Diphtheria-Tetanus triple tetanus 3, 4, 5months, 1.5-2 years old diphtheria tetanus vaccine shall vaccine be paid. Tetanus-diphtheria Combined Vaccine Diphtheria, tetanus 6 years old Free 2 vaccinations at early period of 6 months - 1.5 years old are no Free, but Vero cells epidemic Epidemic encephalitis B vaccine Epidemic encephalitis B need; separately intensify once encephalitis B shall be paid. at 2 years old and 6 years old Group A Meningococcal Epidemic cerebrospinal Separately vaccinate once at 1, Free polysaccharide vaccine meningitis (Group A) 2, 4 and 6 years old Group A+C Meningococcal Epidemic cerebrospinal Above 2 years old Self-pay (including insurance) polysaccharide vaccine meningitis (Group A+C) Self-pay Hepatitis B vaccine(10ug) Hepatitis B All the population Newborn, accidentally infected Self-pay Hepatitis B hyper-immune globulin Hepatitis B population, pregnant of hepatitis B virus carrier Self-pay Hepatitis A vaccine Hepatitis A Above 1 years old Adult / 6-13 years old / 2-5 Self-pay Live Attenuated Varicella vaccine Varicella, herpes zoster years old children Children pneumonia, Self-payHaemophilus Influenzae type B meningitis caused by 2 months - 5 years old vaccine Haemophilus Influenzae type B, etc. Vaccinate 3 times for 6 months Self-pay old (2 months, 3 months and 4 Pneumonia, meningitis, 23-valent pneumococcal months); vaccinate 2 times for 6 otitis media, etc. caused polysaccharide vaccine months old - 1 year old; by pneumococcus vaccinate once for 1 year old to 5 years old Influenza, etc. caused by Self-pay Vaccine by lysis of influenza virus Vaccinate once at 5 years old influenza virus Self-payInfluenza vaccine cleavage vaccine Measles, rubella, mumps Above 2 years old Self-pay Measles and rubella bivalent vaccine Measles, rubella Above 6 months old Self-payMeasles, mumps bivalent vaccine Measles, mumps Above 1 years old Self-payAttenuated live rubella vaccine Rubella Above 1 years old Bivalent live vaccine capsule of Self-pay Bacillary dysentery Above 8 months old dysentery Infantile rotavirus Self-payLive oral rotavirus vaccine Above 1 years old diarrhea Notes: 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 Vaccine Category of Contraindication Reaction Vaccines Hepatitis B vaccine Persons who suffer from hepatitis, fever, acute or Slight reaction, a few people will have chronic disease, serious skin eczema, preterm low blush and induration in the position of body weight, serious viscera deformity and allergic vaccine injection, and will fade away history are forbidden to use this vaccine. 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 1. Persons who have immunodeficiency or are in the Only very few infants will have vaccine period of accepting the therapy of transient diarrhea after being immunosuppressant is forbidden to get vaccinated. vaccinated, and will self-cure. 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. Measles vaccine Persons who have serious diseases, fever or allergic There is no reaction in partial body history (especially who are allergic to eggs) are after rejection. A few persons may forbidden to get vaccinated. have fever, and generally will not exceed 2 days, and someone will have sporadic rash. Pertussis-diphtheria-1. Persons who have epilepsy, nervous system 1. Local part may appear red, pain and tetanus triple disease or convulsions history are forbidden to get tickle or low fever, fatigue, headache, vaccine vaccinated. etc. Generally, there is no need of 2. Persons who have acute infectious disease special treatments, and the symptoms (including rehabilitation stage) or fever are will fade spontaneously. postponed to get vaccinated. 2. Aseptic suppuration 3. 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 1. Persons who have nervous system disease and After rejection, the reaction is alight, vaccine mental disease are forbidden to get vaccinated. and a few people have short-time fever, 2. Persons who have serious disease, such as kidney which often happens at 6 – 8 hours disease, heart disease, active tuberculosis, etc. are after vaccination. Local is flush and the forbidden to get vaccinated. pressure pain, and will gradually fade 3. Persons who have acute infectious disease and after vaccination fever are forbidden to get vaccinated. Epidemic Persons who have fever, acute infectious disease, After rejection, generally there is no encephalitis B otitis media, heart, kidney, liver disease, active reaction, and a very few persons will vaccine tuberculosis, allergic history or convulsions history have local flush, sometimes have fever, are forbidden to get vaccinated; persons who have rash, allergic shock, angioedema, etc. compromised immune system or are accepting immunosuppressive therapy are forbidden to get vaccinated. Informed Consent Form for Vaccination Program Immune Vaccine (1) 1. HIB: hemophilus influenzae B conjugate vaccine 2. Hepatitis A vaccine Preventable diseases: infectious diseases caused by hemophilus influenzae B (meningitis, pneumonia, Preventable diseases: Hepatitis A septicemia, phlegmon, arthritis, epiglottitis, etc.) 1. Allergic people who are known to Hepatitis A inactivation Hepatitis A attenuation be allergic with some content of the 1. People who are not feeling good vaccine, especially to tetanus toxoid, and the body temperature is over or allergic with inoculation of previous 37.5 ?. 1. Patients who have Hepatitis vaccine. and other serious diseases. 2. People who have acute infectious 2. The inoculation shall be delayed 2. Patients of febrile diseases shall disease or other serious diseases. Contraindication during active stage of fever or acute Contraindication delay the inoculation. 3. People who suffer from idiopathic diseases, especially infectious diseases 3. People who are known to be and acquired immune deficiency. or chronic diseases. allergy for any content of the 4. People who are receiving3. Normal reactions of immunization vaccine. immunosuppressive therapy. that can be reduced by 5. Pregnant women and people of immunosuppressive therapy and allergic constitution. immunodeficiency. 1. Partial reactions of injection positions: pain, rubefaction or inflammation. In general, this partial reaction is early-stage, transient and 1. Partial side reactions are slight, and sometimes atypical rash usually pain, and sometimes red can be observed. & swollen, and indurate. 2. Extremely unusual cases may 2. Systematic side reactions appear edema of lower extremity, Possible include headache, fever, nausea, No partial or systematic untoward along with cyanosis or transient reactions after etc. The duration is usually less effect after inoculation of Hepatitis A purpura. This reaction usually appears inoculation than 24 hours, and can relieve by attenuation inactivation vaccine. within the first few hours after self. Possible inoculation, and usually quickly 3. The expectant treatment shall disappears spontaneously without any reactions after be made in time for allergy sequela; there are usually no inoculation reaction. 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 Protective effect 95% lower than 39?), and enhanced excitability and crying appear more often. 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 vaccine Preventable diseases: measles, mumps, rubella. Preventable diseases: water mark – herpes zoster. Domestic Imported 1. People who have serious diseases and 1. Same with other vaccine, people who have fever shall delay the acute serious fever diseases shall delay the People who have serious diseases, inoculation. inoculation, however, for healthy people, slight acute and chronic infection, fever or 2. People who have infection is not immune contraindication. allergic history with eggs shall not allergy history and 2. People whose total lymphocyte is less than inoculate. Contraindication pregnant women shall 1200 / mm3 or proved to lack cellular immune Pregnant women are forbidden to Contraindication be forbidden to use. function shall be forbidden to use. use, fertile women who inoculate 3. Patients of leukemia, 3. People who are known as hypersensitive with shall avoid pregnancy within 3 months tumor, neomycin shall be forbidden to use, but people after inoculation. immunodeficiency, etc. who have contact dermatitis with neomycin are shall use with caution not included in the contraindication. under doctor’s 4. Forbidden to use in pregnancy duration. guidance. 1. Usually no side 1. Healthy people: comprehensive reactogenicity 1. Within 6 to 11 days, few children reaction after injection, of all the age groups are quite low, and the may appear transient fever reaction or occasionally with slight reactions of injection position are usually slight slight rash which will automatically partial reaction. and temporary. Possible relieve less than 2 days. Possible 2. Rarely seen slight or 2. High risk patients: the reactions of injection reactions after 2. Adult women occasionally appear reactions after medium fever, position are usually slight; Papule inoculation slight arthralgia, and need no special inoculation transient eruption for vesiculobullous rash may appear within several treatment normally. Expectant less than 3 days. days or weeks after immune treatment, rarely treatment can be made when Expectant treatment with slight to medium fever, and only less than necessary. can be made when 1/4 leukemia patients have these reactions. necessary. These rashes are usually slight and short. Measles 99% Rubella 99% Mumps Protective effect Protective effect 99% 85% Children’s Planned Immunization Program Immunization Appointment Birth Date: March 15, 2005 Vaccines Date of Date of Meningo-AppointmenVaccine AppointmenVaccine AGE BCG HBV OPV DPT MV Encephalitis coccus A t t Vaccine BaseMarch 31, 0month Base HBIG ? 2015 Morning, BaseNovember 1month influenza ? 13, 2007 vaccine 2month Base? 3 years influenza 3month Base? Base? vaccine 4month Base? Base? Tuesday 5month Base? Morning Base6month ? 7month Base Second 8month 9month 1year 1.5years BooBooster Booster ster 2years Booster Booster 4years Booster Booster Please check if your child has completed the Booster Booimmunization as scheduled 6years Booster Booster DT ster Immunization Appointment Immunization Record (I) Lot Date of Date of Date of Number Unit of Vaccine Vaccine Vaccines Signature Appointment Appointment Immunization of Immunization Vaccine March 15, 2004060 Primaryimm 202+ 2005 47-1 BCG PPD July 21, 2005 12×12 202+ March 15, 2004080First Lina Zhao 2005 2 HBIG Second 202+ Heping District March 15, 2004064 Tuberculosis Control 2005 9 HBV Base April 15, 2005 Gao September 15, 2005902Yuan 2005 -2 Gao May 17, 2005 Base June 27, 2005 Gao September 28, OPV Yuan 2005 2010090 July 14, 2011 District Center Yuan 6 Booster Please check if your child has completed the immunization as scheduled Immunization Record (II) Immunization Record (III) Vaccines Date of Lot Number of Unit of Signature Vaccines Date of Lot Number Unit of Signature Immunization Vaccine Immunization Immunizatioof Vaccine Immunization n DPT Base June 27, 2005 Gao Meningococc1 March 16, 200506 us 2006 1402 A Vaccine July 28, 2005 Yuan 2 June 29, 200506 2006 2903 August 30, 2005 Yuan 3 July 27, 2010 090910 Booster October 8, 2006 Yuan 4 July 30, 2013 DP Booster August 18, 2011 YC37B045AA Gao Rubella Vaccine MV Base November 25, Yuan MMR August 1, 2005 2006 Booster August 1 MM Encephalitis B Base April 18, 2006 200411 Yuan MR Vaccine 2501 April 27, 2006 200411 Chen Varicella June 14, 2501 Vaccine 2006 Booster May 24, 2007 06110301 Yuan June 16, 2011 20110106-1 District Center Gao Pneumococc al Vaccine Immunization Record (IV) Immunization Record (V) Vaccines Date of Lot Unit of Signature Vaccines Date of Lot Unit of Signature Immunization Number Immunization ImmunizaNumber Immuniza Of tion Of tion Vaccines Vaccines HIB 1 Influenza Novembe070729 District Yuan Vaccine r 20, 2007 Center 2 3 4 HAV Attenuation 1 August 27 2 Deactivation 1 May 12, 09141303 Yuan 2011 2 April 19, 20122016 District Gao 2012 Center Influenza Vaccines Record Abnormal Reaction Instructions for Post BCG Vaccination Unit and Conditio1. When BCG has been vaccinated for one month, there will be a blister Unit of Date of Vaccines Lot number n of at the vaccination position, and the pus will flow out. The blister will Immunization Reaction of Product Reaction gradually scab, and this is the normal reaction. 2. The blister shall not be squeezed, pay attention to keep dry and clean, 3. Individual newborn: after vaccinating for about a month, there may be small lumps at left axilla or left clavicle; if the vaccination position still has pus to flow out after three months, please contact various tuberculosis controls. Telephones of the Tuberculosis Controls in each County (City) Heping: 23262448 Dongling: 24821443 Xinmin: 87853562 Record of Infectious Disease Shenhe: 24844095 Yuhong: 25306689 Liaozhong: 87805638 Date of Disease Dadong: 24312094 Sujiatun: 89814846 Faku: 87122890 Infectious Diseases Clinic Huanggu: 86243204 Xinchengzi: 89862700 Kangping: 87347727 Tiexi: 25855402 Hunnan: 23821814 Telephones of Disease Prevention and Control Centers in Various District (County) Heping 23508243 Dongling: 24825287 Faku: 87123543 Shenhe: 31001561 Sujiatun: 89813277 Hunnan: 23825090 Dadong: 24312358 Yuhong: 25308304 Qipanshan: 88050032 Huanggu: 86230946 Xinmin: 62278778 Huishan: 88043445 Tiexi: 62382325 Liaozhong: 87882961 Huishan: 88043445 Xinchengzi: Kangping: 87335887 Remarks 89862118 Mother: HBsAg (+,–) HBeAg (+,–)