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  • Vaccine Adverse Effects Monitoring

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    This document is from the City Health Office in Davao City, Philippines. It contains a vaccine adverse event reporting form to track any adverse effects experienced after vaccination, including the type of vaccine, date of vaccination, adverse effects experienced, date and time of onset, duration of effects, and any interventions. It also provides emergency contact numbers to call in case of adverse effects or emergencies.

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    This document is from the City Health Office in Davao City, Philippines. It contains a vaccine adverse event reporting form to track any adverse effects experienced after vaccination, including the type of vaccine, date of vaccination, adverse effects experienced, date and time of onset, duration of effects, and any interventions. It also provides emergency contact numbers to call in case of adverse effects or emergencies.

    Copyright:

    © All Rights Reserved
    Download as ODT, PDF, TXT or read online from Scribd
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    10 views2 pages

    Vaccine Adverse Effects Monitoring

    Uploaded by

    marabeans
    This document is from the City Health Office in Davao City, Philippines. It contains a vaccine adverse event reporting form to track any adverse effects experienced after vaccination, including the type of vaccine, date of vaccination, adverse effects experienced, date and time of onset, duration of effects, and any interventions. It also provides emergency contact numbers to call in case of adverse effects or emergencies.

    Copyright:

    © All Rights Reserved
    Download as ODT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    Republic of the Philippines

    CITY HEALTH OFFICE


    Davao City
    Tel Nos. (082) 227-4749, (082) 225-3859
    Fax No. (082) 225-3460, Email Address: davaohealth@yahoo.com

    Name of Vaccine: ______________ Vaccine Brand: _____________ Vaccination Date:


    _______
    Adverse Effects Date of Onset Time of Onset Duration of Intervention
    Adverse Effect
    after Vaccination
    (No. of days)
    Pain at the injection        
    site
    Fatigue        
    Headache        
    Chills        
    Arthralgia (Joint        
    Pain)
    Pyrexia (Fever)        
    Others:        
    Note: if any following are observed, please contact these numbers:
    Covid-19 OPCEN Number:
    Globe (Call and Text): +639175086548
    Smart (Call and Text): +639190711111

    In case of emergency, please call 911

    Republic of the Philippines


    CITY HEALTH OFFICE
    Davao City
    Tel Nos. (082) 227-4749, (082) 225-3859
    Fax No. (082) 225-3460, Email Address: davaohealth@yahoo.com

    Name of Vaccine: ______________ Vaccine Brand: _____________ Vaccination Date:


    _______
    Adverse Effects Date of Onset Time of Onset Duration of Intervention
    Adverse Effect
    after Vaccination
    (No. of days)
    Pain at the injection        
    site
    Fatigue        
    Headache        
    Chills        
    Arthralgia (Joint        
    Pain)
    Pyrexia (Fever)        
    Others:        
    Note: if any following are observed, please contact these numbers:
    Covid-19 OPCEN Number:
    Globe (Call and Text): +639175086548
    Smart (Call and Text): +639190711111

    In case of emergency, please call 911

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