SGOD-SHS-NS-066 Rev.

00

Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
Division of Zamboanga del Sur
Dao, Pagadian City

MASTERLIST OF VACCINATED LEARNERS (PEDIATRIC POPULATION)

SY 2022-2023
District: AURORA EAST
School : KAUSWAGAN NATIONAL HIGH SCHOOL
Grade Level/Section: 7 - LOVE & CHARITY

Primary Booster
Vaccination Vaccination With
No. Name of Learner Age Sex 4PS/ Vaccine Vaccine Reported Remarks
IPS Status Type Status Type
AEFI
1st 2nd 1st 2nd

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

Reason for Refusal (indicate number)

No. of Reported
SUMMARY: Enrolment Total Vaccinated AEFI Fear of Disquali- Lack of Religious Other
fied by Trust in the
Injection Physician Vaccine Affiliation Reason

5-11 years old

M 12-18 years old
Total
5-11 years old
F 12-18 years old
Total

AEFI - Adverse Event Following Immunization

Page 1 of
 SGOD-SHS-NS-066 Rev. 00

Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
Division of Zamboanga del Sur
Dao, Pagadian City

MASTERLIST OF VACCINATED LEARNERS (PEDIATRIC POPULATION)

SY 2022-2023
District: AURORA EAST
School : KAUSWAGAN NATIONAL HIGH SCHOOL
Grade Level/Section: 8 - JOY & HOPE

Primary Booster
Vaccination Vaccination With
No. Name of Learner Age Sex 4PS/ Vaccine Vaccine Reported Remarks
IPS Status Type Status Type
AEFI
1st 2nd 1st 2nd

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

Reason for Refusal (indicate number)

No. of Reported
SUMMARY: Enrolment Total Vaccinated AEFI Fear of Disquali- Lack of Religious Other
fied by Trust in the
Injection Physician Vaccine Affiliation Reason

5-11 years old

M 12-18 years old
Total
5-11 years old
F 12-18 years old
Total

AEFI - Adverse Event Following Immunization

Page 2 of
 SGOD-SHS-NS-066 Rev. 00

Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
Division of Zamboanga del Sur
Dao, Pagadian City

MASTERLIST OF VACCINATED LEARNERS (PEDIATRIC POPULATION)

SY 2022-2023
District: AURORA EAST
School : KAUSWAGAN NATIONAL HIGH SCHOOL
Grade Level/Section: 9 - FAITH & DIVINE

Primary Booster
Vaccination Vaccination With
No. Name of Learner Age Sex 4PS/ Vaccine Vaccine Reported Remarks
IPS Status Type Status Type
AEFI
1st 2nd 1st 2nd

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

Reason for Refusal (indicate number)

No. of Reported
SUMMARY: Enrolment Total Vaccinated AEFI Fear of Disquali- Lack of Religious Other
fied by Trust in the
Injection Physician Vaccine Affiliation Reason

5-11 years old

M 12-18 years old
Total
5-11 years old
F 12-18 years old
Total

AEFI - Adverse Event Following Immunization

Page 3 of
 SGOD-SHS-NS-066 Rev. 00

Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
Division of Zamboanga del Sur
Dao, Pagadian City

MASTERLIST OF VACCINATED LEARNERS (PEDIATRIC POPULATION)

SY 2022-2023
District: AURORA EAST
School : KAUSWAGAN NATIONAL HIGH SCHOOL
Grade Level/Section: 10 -WISDOM & GOODWILL

Booster
Primary Vaccination With
4PS/ Vaccine Vaccination Vaccine Reported
No. Name of Learner Age Sex Status
IPS Type Status Type
AEFI
1st 2nd 1st 2nd

1 BATALLA, JOHN VINCENT 15 MALE YES 11-20-21 12-21-21 PFIZER

2 BUHISAN, FRED 15 MALE YES 12-01-21 12-20-21 SINOVAC
3 CAGAS, JOVANIE 15 MALE YES 12-03-21 01-03-22 MODERNA
4 CHAVEZ, JIEBEN 15 MALE YES 12-02-21 12-29-21 MODERNA
5 ERANA, DIOSDADO 15 MALE YES 11-18-21 12-16-21 MODERNA
6 JAYME, JHON MICHAEL 15 MALE YES 12-01-21 12-29-21 MODERNA
7 NAYON, KENRIC 15 MALE YES 12-01-21 12-29-21 MODERNA
8 ABADILLA, CLARENCE 15 MALE YES 12-16-21 01-12-22 PFIZER
9 AUSTIN, JEMBOY 15 MALE YES 12-16-21 01-06-22 PFIZER
10 BANGCARA, ELVIN 18 MALE 12-29-21 JANSSEN
11 BALDICANTOS, JHUNREY 15 MALE YES 12-20-21 01-10-22 PFIZER
12 CARAO, GEMPOL 22 MALE 11-30-21 12-28-21 SINOVAC
13 CUBAR, ANDRIE JAY 15 MALE YES 12-01-21 12-22-21 PFIZER
14 LUMINGKIT, IVAN YEN 15 MALE YES 12-01-22 12-28-21 PFIZER
15 MACRA, JEVIE 15 MALE YES 12-23-21 JANSSEN
16 NAYINGUE, JOHN MARK 15 MALE YES 12-01-21 12-22-21 PFIZER
17 NEBRIL, JOHN ALIMAR 15 MALE YES 01-21-22 JANSSEN
18 UGNAY, ZYLLE 15 MALE YES 12-22-21 01-20-22 MODERNA
19 BENAN, DANICA 15 FEMALE YES 12-01-21 12-29-21 MODERNA
20 BUHISAN, JAYLOU 15 FEMALE YES 11-27-21 12-22-21 PFIZER
21 CAGAS, JAYELL 15 FEMALE YES 12-03-21 01-03-22 MODERNA
22 CANETE, KIMBERLY 15 FEMALE YES 11-24-21 12-15-21 PFIZER
23 ENOMAR, VANICE 15 FEMALE YES 11-24-21 12-15-21 PFIZER
24 JAKOSALEM, CHRISTINE 15 FEMALE YES 12-01-21 12-29-21 MODERNA
25 LLEGUNAS, YONILA 15 FEMALE YES 11-18-21 12-29-21 MODERNA
26 MAGHANOY, CLYZEL MAE 15 FEMALE 12-02-21 12-29-21 MODERNA
27 MAGHANOY, JELINDY 15 FEMALE 12-01-21 12-28-21 MODERNA
28 BANDINGON, MARIEL 15 FEMALE YES 12-01-21 12-22-21 PFIZER
29 BUDIONGAN, CHINHA MAE 15 FEMALE YES 12-01-21 12-22-21 PFIZER
30 MISSION, ANABEL 15 FEMALE YES 12-01-21 12-27-21 PFIZER
31 NAMOC, JELLY FAITH 15 FEMALE YES 11-19-21 12-22-21 MODERNA
32 PARAN, JEE-ANN 15 FEMALE YES 12-21-21 01-11-22 PFIZER
33 PESTOLANTE, HELEN GRACE 15 FEMALE YES 11-30-21 12-28-21 PFIZER

Reason for Refusal (indicate number)

SUMMARY: Enrolment Total Vaccinated No. of Reported AEFI

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 SGOD-SHS-NS-066 Rev. 00

SUMMARY: Enrolment Total Vaccinated No. of Reported AEFI Fear of Disquali- Lack of
Religious
fied by Trust in the
Injection Physician Vaccine Affiliation

5-11 years old

M 12-18 years old 18
Total
5-11 years old
F 12-18 years old 15
Total

AEFI - Adverse Event Following Immunization

Page 5 of
 SGOD-SHS-NS-066 Rev. 00

Remarks

ber)

Page 6 of
 SGOD-SHS-NS-066 Rev. 00

Other Reason

Page 7 of
 SGOD-SHS-NS-066 Rev. 00

Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
Division of Zamboanga del Sur
Dao, Pagadian City

MASTERLIST OF VACCINATED LEARNERS (PEDIATRIC POPULATION)

SY 2022-2023
District: ____________________________
School : ___________________________
Grade Level/Section: _____________________

Primary Booster
Vaccination Vaccination With
No. Name of Learner Age Sex 4PS/ Vaccine Vaccine Reported Remarks
IPS Status Type Status Type
AEFI
1st 2nd 1st 2nd

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

Reason for Refusal (indicate number)

No. of Reported
SUMMARY: Enrolment Total Vaccinated AEFI Fear of Disquali- Lack of Religious Other
fied by Trust in the
Injection Physician Vaccine Affiliation Reason

5-11 years old

M 12-18 years old
Total
5-11 years old
F 12-18 years old
Total

AEFI - Adverse Event Following Immunization

Page 8 of
 SGOD-SHS-NS-066 Rev. 00

Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
Division of Zamboanga del Sur
Dao, Pagadian City

MASTERLIST OF VACCINATED LEARNERS (PEDIATRIC POPULATION)

SY 2022-2023
District: ____________________________
School : ___________________________
Grade Level/Section: _____________________

Primary Booster
Vaccination Vaccination With
No. Name of Learner Age Sex 4PS/ Vaccine Vaccine Reported Remarks
IPS Status Type Status Type
AEFI
1st 2nd 1st 2nd

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

Reason for Refusal (indicate number)

No. of Reported
SUMMARY: Enrolment Total Vaccinated AEFI Fear of Disquali- Lack of Religious Other
fied by Trust in the
Injection Physician Vaccine Affiliation Reason

5-11 years old

M 12-18 years old
Total
5-11 years old
F 12-18 years old
Total

AEFI - Adverse Event Following Immunization

Page 9 of