Student Health & Consent Forms
NO Shot, NO School
Tdap - Tetanus,Diphtheria, Pertussis (whooping cough)
Vaccine required for entry to 7th grade
Effective FALL 2011
Immunization by appointment (call 831-372-6668)
Prepare your students for college or work
Protect teens from vaccine preventable disease
Download consent forms for students under age 18 HERE:
Meningitis is a bacterial infection that affects the lining of the brain. It is transmitted through contact with carriers through coughing, sneezing, kissing or improperly cleaned utensils. The vaccine is recommended for persons who live in close contact with others as in dorms or barracks. Also it is recommended for persons travelling to the ‘meningitis belt’ in sub-Saharan Africa or for pilgrims to the Hajj. The vaccine is a single dose and protects against 4 types of the meningitis bacteria.
Hepatitis A is a serious liver disease caused by the hepatitis A virus. Hepatitis is found in the stool of persons with hepatitis A. It is usually spread by close personal contact and sometimes by eating food or drinking water containing the virus (fecal-oral route). Up to 20% of people who contract hepatitis A often have to be hospitalized. A person who has hepatitis A can easily pass the disease to others within the same household. The vaccine is recommended for all travelers visiting developing countries such as those located in Central or South America, Mexico, Asia (except Japan), Africa, and Eastern Europe.
Symptoms of Hepatitis A: mild “flu-like” illness, jaundice (yellow skin or eyes), severe stomach pains and diarrhea.
Hep A is a 2 shot series. The initial dose provides adequate antibodies in 2 weeks after the injection, and a second dose give 6 months after the first dose will confer a 20 year protection.
Hepatitis B is a serious disease caused by the hepatitis B virus that affects the liver. It is transmitted by contact with blood or body fluids containing the virus. People who are infected can spread Hepatitis B to others, even if they don’t appear sick. Hepatitis B causes sever liver infection and can progress to chronic liver disease and cancer. The vaccine is recommended for prolonged travel, adventure travelers, persons who have unprotected sex, acupuncture, tattoos or a high probability of needing medical care in local healthcare settings.
The vaccine is a three dose series (0, 1 and 6 months) with adequate protection after two doses, the third dose provides lifelong immunity. In certain cases, an accelerated dose schedule may be available.
This vaccine combines the hepatitis A and hepatitis B vaccines together. The benefit of this vaccine is that you receive protection against both Hep A and Hep B with 3 shots, rather than 5 separate shots.
Three doses are given at 0, 1, and 6 months and confer lifelong protection.
In certain cases, an accelerated dose schedule may be available.
Tetanus/diphtheria/pertussis (whooping cough)
Tetanus (Lockjaw) causes painful muscle spasms, usually all over the body. It can lead to tightening of the jaw muscles so the victim cannot open his mouth or swallow. It is contracted through cuts or wounds.
Diphtheria causes a thick covering in the back of the throat. It can lead to breathing problems, paralysis, heart failure, and even death. It is spread by respiratory secretions.
Pertussis (Whooping Cough) is a highly contagious respiratory disease. It causes severe coughing spells, vomiting, and disturbed sleep. It can lead to weight loss, incontinence, rib fractures and passing out from violent coughing.
These three diseases are all caused by bacteria. Everyone should receive a primary Tdap series and a booster every 10 years.
Tetanus vaccine provides protection for 10 years.
HPV Vaccine (Human Papillomavirus – genital warts)
HPV Vaccine is an inactivated vaccine to prevent cervical cancer and genital warts caused by 4 types of HPV. It is currently recommended only for girls and women 9 to 26 years old. Cervical cancer is the 2nd leading cause of cancer deaths among women in the world. 50% of sexually active men and women are infected with HPV at sometime in their lives.
Three doses are given at 0, 2, and 6 months. The duration of protection is expected to be long lasting.
Tuberculin Skin Testing
"TB" is short for tuberculosis. TB disease is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal. TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with active TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected.
The TB skin test (Mantoux tuberculin skin test) is performed by injecting a small amount of fluid (called tuberculin) into the skin in the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm.
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