Republic of the Philippines

DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT

REGION III - BULACAN
OFFICE OF THE PROVINCIAL DIRECTOR

Advisory
January 19, 2022

TO : ALL PROGRAM MANAGER, CLUSTER HEADS,

C/MLGOOs, OIC-C/MLGOOs, AND OTHERS CONCERNED

SUBJECT : INVENTORY OF VACCINATED POPULATION IN THE

BARANGAY IN LINE WITH THE PRONOUNCEMENT OF
PRESIDENT RODRIGO ROA DUTERTE TO RESTRAIN
MOVEMENT OF THE UNVACCINATED INDIVIDUALS

Herewith is the copy of the DILG Memorandum Circular No. 2022-002

dated January 18, 2022 signed by SILG Eduardo M. Año regarding the
above-mentioned subject.

In view hereof, please facilitate the dissemination of the said issuance

to all concerned, and facilitate the completion and uploading of
Barangay Inventory and City/Municipal Inventory for the Month of
January 2022, using the attached templates, through the link
https://tinyurl.com/inventoryofvaxxedJan not later than February 15, 2022.

For compliance

DARWIN D. DAVID
Provincial Director

/fslalu

“Matino, Mahusay at Maaasahan”

Capitol Compound, City of Malolos, Bulacan
Telefax No. (044) 796-1286
 CR: NBOO-2022-01-07-013
2022-01-18-181

002

JAN 18 2022
 BARANGAY MONTHLY INVENTORY OF VACCINATED POPULATION

REGION:_________________
PROVINCE: ________________
CITY/MUNICIPALITY: __________________
BARANGAY: _________________________
A. TOTAL NO. OF POPULATION (AS OF 2020)*: * Note: This shall only cover individuals 13 years old and above.
B. TOTAL NO. OF UNVACCINATED INDIVIDUALS*:
C. PERCENTAGE OF UNVACCINATED INDIVIDUALS*: Formula: B/A x 100
D. TOTAL NO. OF PARTIALLY VACCINATED INDIVIDUALS*:
E. PERCENTAGE OF PARTIALLY VACCINATED INDIVIDUALS*: Formula: D/A x 100
F. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS*:
G. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS*: Formula: F/A x 100
H. TOTAL NO. OF INDIVIDUALS WITH BOOSTER SHOT*:
I. PERCENTAGE OF INDIVIDUALS WITH BOOSTER SHOT*: Formula: H/F x 100
AS OF (insert date): ___________________

Prepared by Approved by

Name and Signature of Barangay Secretary/Health Worker Name and Signature of Punong Barangay

PRIMARY SERIES OF COVID-19 VACCINE

Fully
(Note: 1. If brand is "Janssen, put NA in the column for "2nd Partially BOOSTER DOSE
Unvacinnated? Vacinnated?
Dose"; Put "None" if unvaccinated) vacinnated? (Put 1
No. Full Name (Put 1 if Yes or (Put 1 if Yes
if Yes or With Booster Shot?
Date of Vaccination 0 if No) or
Brand 0 if No) (Put 1 if Yes or Date of Vaccination Brand
0 if No)
1st Dose 2nd Dose 0 if No)
1 EX: JUAN DELA CRUZ June 17, 2021 July 19, 2021 Sinovac 0 0 1 1 January 6, 2021 Moderna
2 EX: JANE DOE October 20, 2021 NA Janssen 0 0 1 0
3 EX: MARIA SANTOS May 27, 2021 Pfizer 0 1 0 0
4 EX. JUANA DELA CRUZ None None None 1 0 0 0
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL 1 1 2 1
 CITY/MUNICIPAL MONTHLY INVENTORY OF VACCINATED POPULATION

REGION:_________________
PROVINCE: ________________
CITY/MUNICIPALITY: __________________
A. TOTAL NO. OF POPULATION (AS OF 2020)*:
B. TOTAL NO. OF UNVACCINATED INDIVIDUALS*:
C. PERCENTAGE OF UNVACCINATED INDIVIDUALS*:
D. TOTAL NO. OF PARTIALLY VACCINATED INDIVIDUALS*:
E. PERCENTAGE OF PARTIALLY VACCINATED INDIVIDUALS*:
F. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS*:
G. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS*:
H. TOTAL NO. OF INDIVIDUALS WITH BOOSTER SHOT*:
I. PERCENTAGE OF INDIVIDUALS WITH BOOSTER SHOT*:
AS OF (insert date): ___________________

Prepared and Submitted by

___________________________
Name and Signature of DILG C/MLGOO

Unvaccinated Individuals Partially Vaccinated Individuals Fully Vaccinated Individuals Individuals with Booster Shot
No. Barangay Total Population

Number Percentage Number Percentage Number Percentage Number Percentage

1 EX: BARANGAY A 160,000 20,000 12.50% 40,000 25.00% 100,000 62.50% 30,000 30.00%
2 EX: BARANGAY B 100,000 30,000 30.00% 20,000 20.00% 50,000 50.00% 10,000 20.00%
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
TOTAL 260,000 50,000 19.23% 60,000 23.08% 150,000 57.69% 40,000 26.67%
 PROVINCIAL MONTHLY INVENTORY OF VACCINATED POPULATION

REGION:_________________
PROVINCE: ________________
A. TOTAL NO. OF POPULATION (AS OF 2020)*:
B. TOTAL NO. OF UNVACCINATED INDIVIDUALS*:
C. PERCENTAGE OF UNVACCINATED INDIVIDUALS*:
D. TOTAL NO. OF PARTIALLY VACCINATED INDIVIDUALS*:
E. PERCENTAGE OF PARTIALLY VACCINATED INDIVIDUALS*:
F. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS*:
G. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS*:
H. TOTAL NO. OF INDIVIDUALS WITH BOOSTER SHOT*:
I. PERCENTAGE OF INDIVIDUALS WITH BOOSTER SHOT*:
AS OF (insert date): ___________________

340,000
Prepared by: Submitted by:

___________________________ ___________________________
Name and Signature of DILG Provincial Office Focal Person Name and Signature of DILG Provincial Director

Partially Vaccinated Individuals with Booster

Unvaccinated Individuals Fully Vaccinated Individuals
Individuals Shot
No. City/Municipality Total Population

Number Percentage Number Percentage Number Percentage Number Percentage

1 EX: City A 1,160,000 280,000 24.14% 540,000 46.55% 340,000 29.31% 70,000 20.59%
2 EX: Municipality A 1,100,000 230,000 20.91% 420,000 38.18% 450,000 40.91% 100,000 22.22%
3 EX: Municipality B 1,800,000 340,000 18.89% 540,000 30.00% 920,000 51.11% 320,000 34.78%
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL 4,060,000 850,000 20.94% 1,500,000 36.95% 1,710,000 42.12% 490,000 28.65%
 REGIONAL MONTHLY INVENTORY OF VACCINATED POPULATION

REGION:_________________
A. TOTAL NO. OF POPULATION (AS OF 2020)*:
B. TOTAL NO. OF UNVACCINATED INDIVIDUALS*:
C. PERCENTAGE OF UNVACCINATED INDIVIDUALS*:
D. TOTAL NO. OF PARTIALLY VACCINATED INDIVIDUALS*:
E. PERCENTAGE OF PARTIALLY VACCINATED INDIVIDUALS*:
F. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS*:
G. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS*:
H. TOTAL NO. OF INDIVIDUALS WITH BOOSTER SHOT*:
I. PERCENTAGE OF INDIVIDUALS WITH BOOSTER SHOT*:
AS OF (insert date): ___________________

Prepared by: Submitted by:

___________________________ ___________________________
Name and Signature of DILG Regional Office Focal Person Name and Signature of DILG Regional Director

Partially Vaccinated Individuals with Booster

Unvaccinated Individuals Fully Vaccinated Individuals
Individuals Shot
No. PROVINCE/HUC/ICC Total Population

Number Percentage Number Percentage Number Percentage Number Percentage

1 EX: HUC A 960,000 80,000 8.33% 540,000 56.25% 340,000 35.42% 50,000 14.71%
2 EX: HUC B 1,000,000 130,000 13.00% 420,000 42.00% 450,000 45.00% 70,000 15.56%
3 EX: ICC A 1,200,000 40,000 3.33% 240,000 20.00% 920,000 76.67% 320,000 34.78%
4 EX: Province A 1,800,000 340,000 18.89% 540,000 30.00% 920,000 51.11% 170,000 18.48%
5 EX: Province B 3,000,000 540,000 18.00% 1,140,000 38.00% 1,320,000 44.00% 420,000 31.82%
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL 7,960,000 1,130,000 14.20% 2,880,000 36.18% 3,950,000 49.62% 1,030,000 26.08%