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Health Supervision

Immunizations: Documentation

When documenting immunizations, consider the following:

If the child's immunization history is based on a verbal report of the parent or other responsible adult, you must:

  • Confirm immunization history through the child’s previous health care provider, school, or day care center.
  • Properly document the information (vaccine dates and source) in the medical record.

If the child’s immunizations are not up to date according to age and health history, you should:

  • Document the reason why immunizations were not given based on the recommended ACIP schedule.

If verbal reports of vaccine dates cannot be verified:

  • Repeat the immunizations.
  • Be aware that for measles, mumps, and rubella, serological evidence of immunity to all three antigens is an acceptable alternative.

If immunization records are missing:

  • Contact the DC Central Immunization Registry at (202) 576-7130, ext. 7.

 

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