VACCINATION REPORT PEDIA (12-17 y/o)

NAME OF SCHOOL: MALIMPIN NATIONAL HIGH SCHOOL TOTAL NUMBER OF

ENROLEES: 34
GRADE LEVEL: 12 GAS & TVL

NO NAME OF STUDENT VACCINE FIRST DOSE SECOND DOSE SIDE EFFECTS

Place of Vaccination RESIDENCE Birthday AGE COMORBIDITY
1 LGU Dasol, Pangasinan BALATICO, JULIUS LIM SAN PEDRO MABINI 12/4/2004 17 Sinovac 1/12/2021 12/22/21 headache none
2 LGU Dasol, Pangasinan BASUEL, ADRIAN PADAMA MALIMPIN DASOL 09/24/2003 18 Astrazeneca 11/19/21 1/19/21 pain at site none
3 LGU Dasol, Pangasinan BONIOL, GEOMAR CABRIDO MALIMPIN DASOL 9/5/2004 17 Pfizer 12/22/21 12/1/2022 none none
4 LGU Dasol, Pangasinan BONROSTRO, MARC JEREMY CLAVMALIMPIN DASOL 7/12/2003 17 Pfizer 10/11/2021 1/12/2021 pain at site none
5 LGU Dasol, Pangasinan BUSTRIA, DANILO CATABAY MALIMPIN DASOL 01/23/2004 17 Pfizer 11/11/2021 2/12/2021 pain at site none
6 LGU Dasol, Pangasinan CABRIDO, ROGER JR. LAGASCA MALIMPIN DASOL 06/13/2004 17 Pfizer 11/22/21 1/14/22 none none
7 LGU Dasol, Pangasinan DEL ROSARIO, JUNIOR CALAMNO MALIMPIN DASOL 1/3/2004 17 Pfizer 12/16/21 6/1/2022 none none
8 LGU Dasol, Pangasinan HUMILDE, JC OLANDRES MALIMPIN DASOL 2/6/2004 17 Pfizer 11/15/21 6/12/2021 pain at site none
9 LGU Dasol, Pangasinan MERU, DAN DE LEON MALIMPIN DASOL 05/20/2002 19 Astrazeneca 11/22/21 1/2/2021 none none
10 NAVAL, JOMAR QUIZON MALIMPIN DASOL 11/17/2003 17
11 LGU Dasol, Pangasinan NOCES, ARDEE MISA MALIMPIN DASOL 11/6/2002 19 Astrazeneca 11/22/21 1/2/2021 pain at site none
12 LGU Dasol, Pangasinan TORRES, MARVIN FLORES MALIMPIN DASOL 07/27/2004 17 Pfizer 11/15/21 6/12/2021 headache none
VALDEVARONA, JOHN CARLO
13 LGU Dasol, Pangasinan PAGARIGAN MALIMPIN DASOL 06/13/2004 17 Pfizer 12/11/2021 3/12/2021 none none
14 AGUINALDO,ARIEZ JR MERU SAN VICENTE DASOL 02/13/1998 23
BALISALISA, JOHN LLOYD
15 LGU Dasol, Pangasinan HUMILDE MALIMPIN DASOL 03/20/2003 18 Sinovac 11/29/21 12/27/21 pain at site none

16 LGU Dasol, Pangasinan BALISALISA, MARK JIAN SANTILLA MALIMPIN DASOL 01/20/2004 17
17 LGU Dasol, Pangasinan BRIVA, JERALD NITUYA MALIMPIN DASOL 2/5/2003 18 Astrazeneca 11/22/21 2/2/2022 none none
18 LGU Dasol, Pangasinan CORPUZ, AXL JENAN BELECINA MALIMPIN DASOL 08/13/2001 20 Astrazeneca 1/12/2021 fever and headache none
NARCISO, DAVID CHRISTIAN
19 LGU Dasol, Pangasinan BUSTAMANTE MALIMPIN DASOL 7/9/1999 22 Pfizer 10/15/21 5/11/2021 none none
20 LGU Dasol, Pangasinan NAVIDA, STEVEN KYLE MINOS MALIMPIN DASOL 01/31/2004 17 Pfizer 11/22/21 12/14/21 headache none
21 LGU Dasol, Pangasinan RAMIREZ, LEO BODINO MALIMPIN DASOL 09/19/2003 18 Moderna 10/28/21 11/25/21 headache none
22 LGU Mabini, Pangasinan VIDAL, JOMARI CALLE SAN PEDRO MABINI 4/2/2002 19 Sinovac 9/22/21 6/10/2021 none none
23 LGU Dasol, Pangasinan VITON, STEVEN SHANE NAVIDA 2/2/2003 18
24 LGU Mabini, Pangasinan AFGAO, RAQUEL DAMASEN SAN PEDRO MABINI 08/22/2003 18 Pfizer 1/12/2021 12/22/21 none none
25 LGU Dasol, Pangasinan BALAOING, MARILOU MENES MALIMPIN DASOL 10/22/2003 18 Sinovac 11/28/21 12/28/21 headache none
26 LGU Dasol, Pangasinan BALISALISA, LEA MAE HUMILDE MALIMPIN DASOL 06/25/2004 17 Pfizer 11/15/21 6/12/2021 pain at site none
27 LGU Dasol, Pangasinan BATINGAN, ERNA ME BUSTAMANTMALIMPIN DASOL 09/13/2003 18 Astazeneca 11/17/21 1/31/22 pain at site none
28 LGU Dasol, Pangasinan BELECINA, MICHELLE RAMIREZ MALIMPIN DASOL 12/28/2002 19 J&J 12/1/2022 pain at site none
29 LGU Dasol, Pangasinan BUSTAMANTE, JOY SAWAYSAWAYMALIMPIN DASOL 5/3/2004 17 Pfizer 11/17/21 8/12/2021 none none
30 LGU Dasol, Pangasinan BUSTRIA, RONA MARIE BALLEN MALIMPIN DASOL 07/17/2004 17 Pfizer 11/11/2021 2/12/2021 headache none
31 LGU Mabini, Pangasinan CUARESMA, MABEL NONAT SAN PEDRO MABINI 10/23/2003 18 Pfizer 4/11/2021 11/25/21 none none
32 LGU Dasol, Pangasinan DUGAY, LOIDA ABUAN MALIMPIN DASOL 08/17/2004 17 Pfizer 12/13/21 4/1/2022 pain at site none
33 LGU Dasol, Pangasinan LAGASCA, MARIANE VELONZA MALIMPIN DASOL 11/9/2004 17 Pfizer 11/15/21 6/12/2021 headache none
34 LGU Dasol, Pangasinan VALDEVARONA, REGINE BUSTAMANT MALIMPIN DASOL 09/17/2004 17 Pfizer 11/29/21 12/21/21 headache none

Prepared by:
JAYBE M. MOVILLA
Class Adviser