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Click ‘Get Form’ to open the Pediatric Immunization Record in the editor.
Begin by entering the child's last name, first name, and date of birth. This information is crucial for accurate record-keeping.
Fill in the mother’s maiden name and gender of the child. These details help identify the patient uniquely.
In the vaccine section, list each vaccine administered along with its date given, type, manufacturer, lot number, route (IM or SC), and dosage. Ensure all fields are completed as required by federal law.
Document any history of vaccine reactions by marking the appropriate box. If vaccines were given elsewhere, indicate this in the designated column.
Finally, ensure that a signature from the vaccine administrator is included along with their title. This validates the immunization record.

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Do kids get shots at their 10 year check-up?

If you had your routine immunizations on schedule, you need an extra dose (booster) of Tdap at the following times: in Grade 9 (If your child already had a dose when they were at least age 12 years, they do not need a dose in Grade 9.) every 10 years as an adult.

What immunization do you get every 10 years?

Td/Tdap every 10 years for all adults.

What vaccines should adults get every 10 years?

Tetanus, diphtheria, pertussis (Tdap). Tdap can protect you from lockjaw, which also is called tetanus; whooping cough, which also is called pertussis; and diphtheria, which can lead to breathing problems. A Tdap booster shot is recommended every 10 years.

Which vaccination is given at 10 years?

Tetanus, diphtheria and acellular pertussis (Tdap), dose one (one dose in childhood, but every 10 years for life). Human papillomavirus (HPV), dose one and dose two, separated by at least five months. Your child can begin this series prior to their 11th birthday starting at age 9.