COVID-19 Vaccine Informed Consent for Children

COVID-19 Vaccine Informed Consent for Children
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Link to Covid-19 VIS
Please be advised: Prescriptions will only be provided upon confirmation of vaccination status.
Confirmed pharmacy has the vaccine:

Yes
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At JMA Pediatrics, we follow the American Academy of Pediatrics (AAP) vaccine plan. It is based on the latest scientific proof and expert consensus. The AAP recommends the COVID-19 vaccine for children ages 6–23 months. It also recommends the vaccine for older children who are at higher risk or whose families wish protection. This is different from the CDC’s guidance, which does not include routine COVID-19 vaccines for healthy children.

We want to make sure you know the benefits, risks, and choices. The AAP’s plan is based on data showing that young children are at higher risk of a hospital stay from COVID-19, even without existing health problems. The vaccine has been shown to be safe and helpful in preventing severe sickness.

You have the choice to decline or put off vaccination. If you choose to proceed, we will record your consent and give you the COVID-19 Vaccine Information Statement (VIS). The VIS outlines the vaccine’s purpose, risks, and side effects. If you have any questions or concerns, we are here to discuss them with you.

I have read the above and the COVID-19 VIS sheet. I voluntarily consent to the administration of the COVID-19 vaccine to my child.
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