H1N1 Consent Letter download

H1N1 Consent Form download

"What you need to know" download

Posted October 23, 2009

Dear Parents/Guardians:

As you may have heard, a new influenza virus, called the 2009 H1N1 influenza virus, was first identified in the United States in late April 2009.  The virus has caused illness ranging from mild to severe, including hospitalizations and deaths in adults and children. Many children have gotten 2009 H1N1 infection and there have been large outbreaks in some schools across the country. The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices has recommended that children and young adults aged 6 months through 24 years be vaccinated against 2009 H1N1 as soon as the vaccine is available.  Other groups recommended to get the first doses of 2009 H1N1 influenza vaccine are: 

1.     Pregnant women

2.     People who live with or care for children younger than 6 months of age

3.     Health care providers and emergency medical services workers

4.     People ages 25 through 64 years who have underlying chronic medical conditions that may complicate flu symptoms, such as HIV, diabetes, or heart or lung disease (including asthma).

Vaccination is the best way to protect your child from this potentially serious disease.  The Greater Sullivan County Public Health Network, in conjunction with the Lake Sunapee Visiting Nurse’s Association and Hospice, are working with your child’s school to give the 2009 H1N1 influenza vaccine to children at school.  We will hold vaccination clinics beginning this fall, and your child’s school will let you know the specific dates once vaccine is on hand.  Children 9 AND UNDER are expected to need two doses of vaccine spaced about 3-4 weeks apart.  There will be no cost to you or the school district for this vaccine.  Parents should be checking the DISTRICT website which will be updated as soon as dates are available.

The “Vaccine Consent Form” included in this mailing allows you to either accept or refuse the vaccination for your child.  If you refuse, the vaccination will not be given to your child.  To accept the vaccination, you can read the “WHAT YOU NEED TO KNOW” flyer included with this letter about the disease and the vaccine.  You must then sign and date the included consent form to accept vaccination for your child and return it to the school.  If you accept vaccination, the vaccine will be given to your child when it is on hand.  School staff will let you know when the vaccination clinic will take place about one week before.  If, at any time, you change your mind about having your child vaccinated, you must contact your child’s school nurse, who will send you another “Vaccine Consent Form” for you to complete again indicating your change.  Giving consent early will ensure that your child is ready to receive the vaccine as soon as it is on hand.

Please realize there are two other ways you may be able to get your child vaccinated for the H1N1 virus.  Your child’s health care provider can answer your questions about the 2009 H1N1 influenza virus, will be able to give your child the seasonal influenza vaccine and may be able to give your child the 2009 H1N1 vaccine.  You may also be able to get your child vaccinated at one of the regional “Points of Distribution” (POD) that will be set up around the state.  As soon as we know the dates, times and locations of these regional PODs, we will send that information home to you.

If you have any questions about the vaccine, for general public health related questions, including H1N1, please call 603-271-4496 (8:30 AM - 4:30 PM regular business days), or 603 –271 –5300, or 1-800-852-33345 ext. 5300 after hours.  You may also look for information on the NH Department of Health and Human Services website at www.dhhs.state.nh.us.  Please also visit the CDC’s 2009 H1N1 influenza web sites at http://www.cdc.gov/h1n1flu/ and http://www.cdc.gov/h1n1flu/parents for more information especially for parents.

If you have any questions about the school vaccination clinics, please contact your child’s school nurse.