Influenza Vaccine

Screening checklist for contraindications to inactivated injectable influenza vaccine. 

For patients to be vaccinated: The following questions will help determine if there is any reason we should not give your child inactivated injectable influenza vaccination today. If you answer "YES" to any question, it does not necessarily mean your child should not be vaccinated. It just means additional questions must be asked. If a question is not clear, please ask your healthcare provider to explain it.

Is the person to be vaccinated sick today?
Does the person to be vaccinated have an allergy to a component of the vaccine?
Has the person to be vaccinated ever had a serious reaction to the influenza vaccine in the past?
Has the person to be vaccinated ever had Guillain-Barre' Syndrome?

275 SE Cabot Dr., Suite B-102 

Oak Harbor, WA 98277

360-675-5555

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1690 Layton Rd.

Freeland, WA 98249

360-331-1314