BARANGAY MONTHLY INVENTORY OF VACCINATED POPULATION

REGION:
PROVINCE:
CITY/MUNICIPALITY:
BARANGAY:
A. TOTAL NO. OF POPULATION (AS OF 2020)*: 4,546
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:

Prepared by Approved by

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

PRIMARY SERIES OF COVUD-19 VACINNE Unvaccinated Partially Fully

Full Name (Note 1. If brand is “Janssen, put NA in the (Put 1 if Yes vaccinated? vaccinated? BOOSTER DOSE
column for “2nd Dose”; put “None” if or 0 if No) (Put 1 if Yes or (Put 1 if yes or
unvaccinated) 0 if No) 0 if No)
Date of Vaccination Brand With Date of
1st Dose 2nd Dose Booster Vaccination Brand
Shot?
(Put 1 if yes
or 0 if No)