Vaccine Forms and Information

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Public Readiness & Emergency Prepardness (PREP) Act - (10/6/09)

Guidance for providers from CMS on billing for H1N1 Vaccinations - (9/3/09)

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Information about Ancillary Supplies shipped with Vaccine

2009 H1N1 Influenza Vaccine Ancillary Kit Description (10/26/09)

"2009 H1N1 Monovalent Influenza Vaccine Ancillary Supply Kit Overview", November 12, 2009

BD Eclipse Needles, Important Usage Information (10/26/09)

BD Integra Syringe (10/26/09)

BD Safety Lok Sliding Sleeve Syringe (10/26/09)

BD SafetyGlide Needle (10/26/09)

Monoject Magellan Safety Needle (10/26/09)

Monoject Safety Needle (10/26/09)

VanishPoint Syringes (10/26/09)

BD (Becton Dickinson) Just-in-time Training Website

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For Providers Who Have Requested H1N1 Vaccine

H1N1 Vaccine Report Form - (10/1/09)

H1N1 Consent Form- (10/1/09)

H1N1 Vaccine Administration Form- (10/1/09) Required

Handling Instructions for 2009 H1N1 Vaccine - (9/16/09)

2009 H1N1 Influenza Vaccine LIVE, Attenuated - (10/2/09)

Vacuna contra la influenza 2009 H1N1 - (10/2/09)

2009 H1N1 Influenza Vaccine INACTIVATED - (10/2/09)

Vacuna contra la influenza 2009 H1N1 Inactivada ("vacuna inyectable"): - (10/2/09)

Reporting Possible Adverse Events Following Vaccination with H1N1 Vaccine - (10/5/09)

H1N1 Influenza Vaccince Order Form (12/17/09)

NMDOH_H1N1_Vaccine_Transfer_Form - (11/13/09)

Influenza A (H1N1) 2009 Monovalent Vaccine Dosage Chart

H1N1 Vaccine Report Form - (10/01/09)

NMDOH PHD H1N1 consent form - (12/03/09)

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Additional Resources

Use of Influenza A (H1N1) 2009 Monovalent Vaccine - Recommendation of ACIP

Prevention Of Pneumococcal Infections Secondary To Seasonal And 2009 H1N1 Influenza Viruses Infection

Questions and Answers: Emerging Infectious Diseases (EID) article "Estimates of the Prevalence of Pandemic (H1N1) 2009, United States, April-July 2009"

2009 H1N1 Influenza Vaccine and Pregnant Women: Information for Healthcare Providers

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