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COVID-19 Vaccination Packet Contents Include: Informational Letter Reflections: - Prayer for a Time of Pandemic - A Reflection on Social Distancing Janssen (J&J) COVID-19 Vaccine Consent Form COVID-19 Vaccine FAQs V-safe After Vaccination Health Checker

COVID-19 Vaccination Packet

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Page 1: COVID-19 Vaccination Packet

COVID-19 Vaccination Packet Contents Include:• Informational Letter• Reflections:

- Prayer for a Time of Pandemic- A Reflection on Social Distancing

• Janssen (J&J) COVID-19 Vaccine Consent Form• COVID-19 Vaccine FAQs• V-safe After Vaccination Health Checker

Page 2: COVID-19 Vaccination Packet

We are thrilled to be able to offer you the COVID-19 vaccine at this time. Getting vaccinated can help save your life and protect the lives of others. It’s the best way to prevent getting sick with COVID-19. COVID-19 vaccines are a highly effective tool to help stop the pandemic. All available vaccines provide excellent protection against severe COVID-19 infection and significantly reduce the likelihood of hospitalization or death, and they are safe.

For your convenience, our staff can administer the COVID-19 vaccine during your hospital stay. Your safety is our top priority; please know the COVID-19 vaccines have all received Emergency Use Approval (EUA) from the Food and Drug Administration (FDA), which means they have undergone rigorous testing and large-scale human trials that have proven both vaccines to be safe and effective.

After receiving the vaccine, you may have some side effects, which are normal signs that your body is building protection. The most common side effects are pain at the injection site, fever, and chills. These side effects tend to be mild to moderate and go away on their own within 1–2 days. We will monitor you closely for any potential allergic reactions for 15 minutes after your injection. During the remainder of your stay with us, we will continue to watch for any additional symptoms. If you have a smartphone, we also encourage you to enroll in v-safe. This CDC tool makes it easy to report any side effects after getting a COVID-19 vaccine. If you report serious side effects, someone from CDC will call to follow up.

For your information, we’ve included the following resources in this packet:

• V-safe after vaccination health checker • Vaccine card (present this card if you will receive a second dose as part of a 2-dose series) • Vaccine cardholders • Vaccination FAQs • Consent Form • Information about the second dose if not J&J?

Receiving the vaccination does not mean you can ignore COVID-19 restrictions. Despite being fully vaccinated, people are still encouraged to take precautions and follow current guidance, such as wearing a mask and washing their hands often. However, as you may already know, the Centers for Disease Control and Prevention (CDC) published the following Interim Public Health Recommendations for Fully Vaccinated People. These recommendations allow fully vaccinated people to:

• Visit with other fully vaccinated people indoors without masks or physical distancing • Visit with unvaccinated people from a single household who are at low risk for severe COVID-19

disease indoors without wearing masks or physical distancing • Refrain from quarantine and testing following a known exposure if asymptomatic

You will be considered fully vaccinated two weeks after you have received the second dose in a 2-dose series (Pfizer or Moderna), or two weeks after you receive a single-dose vaccine (Johnson and Johnson).

If you have any questions, please reach out and talk with your care team. We want you to feel confident in your decision to get vaccinated and welcome any questions you may have.

Sincerely,

Page 3: COVID-19 Vaccination Packet

Prayer for a Time of PandemicBy Cameron Bellm www.ccvichapel.org/post/prayer-for-a-pandemic-cameron-bellm

May we who are merely inconvenienced remember those whose lives are at stake.

May we who have no risk factors remember those most vulnerable.

May we who have the luxury of working from home remember those who must choose between preserving their health or making their rent.

May we who have the flexibility to care for our children when their schools close remember those who have no options.

May we who have to cancel our trips remember those that have no safe place to go.

May we who are losing our margin money in the tumult of the economic market remember those who have no margin at all.

As fear grips our country, let us choose love. During this time when we cannot physically wrap our arms around each other, let us yet find ways to be the loving embrace of God to our neighbors.

Amen.

©The Catholic Health Association of the United States

Page 4: COVID-19 Vaccination Packet

A Reflection on Social DistancingBy Rabbi Yosef Kanefsky, B’nai David-Judea Congregation, a Modern Orthodox Synagogue in Los Angeles

One of the brand new terms that has entered our daily conversation is “social distancing.” It is shorthand, as we know very well, for the practical physical precautions that we all need to and must take in order to protect ourselves and others. I’d humbly suggest though, that we use the term itself sparingly, if at all. Language is a powerful shaper of thinking. And the very last thing we need right now, is a mindset of mutual distancing.

We actually need to be thinking in the exact opposite way. Every hand that we don’t shake must become a phone call that we place. Every embrace that we avoid must become a verbal expression of warmth and concern. Every inch and every foot that we physically place between ourselves and another, must become a thought as to how we might be of help to that other, should the need arise. It is obvious that “distancing”, if misplaced or misunderstood, will take its toll not only upon our community’s strength and resiliency, but upon the very integrity and meaning of our spiritual commitment.

Let’s stay safe. And let’s draw one another closer in a way that we’ve never done before.

©The Catholic Health Association of the United States

Page 5: COVID-19 Vaccination Packet

Version date: 3/1/2021 (v1)

Janssen (J&J) COVID-19 Vaccine Consent Form Facility: ____________________ (The Facility)

Section 1: Personal Information (please print or affix patient sticker)

NAME (Last)

(First) (M.I.)

DATE OF BIRTH month_________ day________ year __________ PHONE NUMBER SEX ASSIGNED AT BIRTH

M / F

Section 2: Screening for Vaccine Eligibility YES NO Have you had a severe allergic reaction to any ingredient in the Janssen COVID-19 vaccine? Components of the Janssen COVID-19 Vaccine: recombinant replication-incompetent adenovirus type 26 expressing the SARS-CoV-2 spike protein, citric acid monohydrate, trisodium citrate dihydrate, ethanol, 2-hydroxypropyl-β-cyclodextrin (HBCD), polysorbate-80, sodium chloride.

Are you below the minimum age requirement (18 years) for receiving the Janssen COVID-19 vaccine?

Have you received a previous COVID-19 vaccine made by a different manufacturer? Have you received any other vaccines in the last 14 days? Have you received any monoclonal antibodies or convalescent plasma to treat COVID-19 in the last 90 days?

If ‘no’ answers to every question, progress to the next section. For ‘yes’ answers, please seek guidance. Section 3: Consent for Vaccination

• I have been offered and have read or had explained to me the COVID-19 Vaccine Screening Questions and Guidance.

• I also have been offered and have read or had explained to me the Fact Sheet for Patients and Parents/Caregivers for the Janssen COVID-19 Vaccine that I am receiving today (the COVID-19 Vaccine).

• I understand the risks and benefits of receiving the COVID-19 Vaccine. • I understand the COVID-19 Vaccine went through a special process called an emergency use authorization

(EUA). The COVID-19 Vaccine has not been fully reviewed and approved by the FDA. • I understand the potential risks, including serious allergic reactions (anaphylaxis). Other reported adverse

reactions include injection site reactions (pain, swelling, or redness) and general side effects (headache, feeling very tired, muscle aches, nausea and fever).

• I understand there may be other potential ways to prevent COVID-19. • I was given the chance to ask questions and all questions were answered. • I agree to receive the Janssen COVID-19 Vaccine.

� I GIVE CONSENT to The Facility and its staff to vaccinate me with the COVID-19 Vaccine. (If you choose this option but do not sign below, then you will not be vaccinated).

Signature of Recipient/Healthcare Proxy ___________________________________ Date: month___day___year____

Affix patient sticker here.

SFO Medical Clinic

Address __________________________City ________________ Zip Code _________ Country _________

State ________

Page 6: COVID-19 Vaccination Packet

COMPLETE THIS PAGE ONLY IF CONSENT TO RECEIVE THE COVID-19 VACCINE IS GIVEN.

Section 4: Vaccination Record

FOR ADMINISTRATIVE USE ONLY Vaccine Manufacturer Date Dose Administered Lot Number Dose Name of Vaccine Administrator

Janssen

/ /

☒ 1st and only dose

Section 5: Notice of Privacy Practices

• I have been offered The Facility’s Notice of Privacy Practices. • By signing below, I acknowledge receipt of the Notice of Privacy Practices.

Signature of Recipient/Healthcare Proxy ___________________________________ Date: month___day___year____ Section 6: Consent to Bill/Assignment of Benefits

• I will not be personally responsible for any cost or fee associated with the COVID Vaccine. • If I am a beneficiary under any insurance or health plan or government-sponsored program (Plan/Program), I

understand that the Plan/Program may be billed for the administration of the COVID Vaccine. • I assign to The Facility any benefits under my Plan/Program for the administration of the COVID Vaccine. • I authorize The Facility to directly bill my Plan/Program for the administration of the COVID Vaccine. • I instruct my Plan/Program to directly pay The Facility any benefits to which I am entitled for the administration

of the COVID Vaccine. • I authorize The Facility to keep any payment received from my Plan/Program for the administration of the

COVID Vaccine. Signature of Recipient/Healthcare Proxy ___________________________________ Date: month___day___year____

Site: Left / Right Deltoid Time: __________

Page 7: COVID-19 Vaccination Packet

COVID-19 Vaccine FAQs

Vaccine Safety Ethical Concerns Pfizer, Moderna, and Johnson & Johnson Vaccine FAQ Additional Information

Vaccine Safety

- How do we know if the COVID-19 vaccine is safe? The care and safety of our employees and the patients we serve is always our top priority. As with any vaccine, CommonSpirit Health will not administer a COVID-19 vaccine unless the FDA has determined it is safe and effective. CommonSpirit clinical leaders have reviewed clinical trial data and evidence for the vaccines, and concur with the FDA authorization.

- How long after the 2nd dose are you theoretically immune? Early findings suggest that some antibodies are produced within a few weeks after the first dose, but it will take longer for full immunity to be achieved. The duration of protection is unknown.

- What are the long-term effects of COVID-19?

Experts have found that some patients experience long-term effects of COVID-19 that impact quality of life. Long-term symptoms can include ongoing respiratory, cardiac, neurologic and cognitive issues, in patients who had both mild and severe cases of COVID-19.

- Did the vaccine clinical trials include participants from diverse racial/ethnic

backgrounds? Yes. Among the total participants in the Pfizer-BioNTech COVID-19 Vaccine trial, 9.1 percent were Black or African American, 28.0 percent were Hispanic/Latino, 4.3 percent were Asian, and 0.5 percent were American Indian/Alaska native. For the Moderna clinical trials, 20.5% of participants identified themselves as Hispanic or Latino, 10.2% as African American or Black, 4.6% as Asian, 0.8% as American Indian or Alaska Native, 0.2% as Native Hawaiian or other Pacific Islander, 2.1% identified their race as other, and 2.1% as multiracial. In the Johnson & Johnson trial, 45.3% of participants identify as Hispanic/Latino, 19.4% Black or African American, 9.5% American Indian or Alaska Native, 3.3% Asian, 0.2% Native Hawaiian or other Pacific Islander, and 5.6% Multiracial. Data provided by the FDA.

Updated 3/11/21

Page 8: COVID-19 Vaccination Packet

- Should I get the vaccine if I have an autoimmune disease? According to the CDC, people with autoimmune conditions may receive a COVID-19 vaccine. However, they should be aware that no data are currently available on the safety of mRNA COVID-19 vaccines for them. Individuals from this group were eligible for enrollment in clinical trials.

Ethical Concerns

- Are there any moral or ethical concerns related to the way the vaccines were developed? The Vatican, the U.S. Conference of Catholic Bishops (USCCB), the Catholic Health Association, and other respected sources have found all COVID-19 vaccines to be morally acceptable. The Pfizer and Moderna COVID-19 vaccines do not use any cell lines derived from abortions in their production process but did use them in the testing process. The Janssen/Johnson and Johnson vaccine uses cell lines in both the testing and production process. The Vatican and USCCB are clear it is morally acceptable to use all effective, approved COVID-19 vaccines given the importance of protecting individuals and others, and how far removed the abortions are from vaccine production. Since the Janssen/Johnson & Johnson vaccine is more closely tied to cell lines derived from abortion, Catholics should choose an alternative vaccine if one is available to them. Unfortunately, practical considerations make this unlikely to be possible for the foreseeable future. Consistent with other Catholic health systems and the Vatican’s statement that “all vaccinations recognized as clinically safe and effective can be used in good conscience,” CommonSpirit Health will be utilizing all safe and effective vaccines to prevent further harm from COVID-19.

Pfizer, Moderna and Janssen/Johnson & Johnson Vaccine FAQ FAQs Adopted from: COVID-19 ACIP Vaccine Recommendations

- What are the possible side effects of the Pfizer-BioNTech COVID-19 Vaccine?* o injection site pain o tiredness o headache o muscle pain o chills o joint pain o fever o injection site swelling o injection site redness o nausea o feeling unwell o swollen lymph nodes (lymphadenopathy)

It is recommended that people with allergies to components of the vaccine not vaccinate. There is a remote chance that the Pfizer-BioNTech COVID-19 Vaccine could cause a severe allergic reaction. A severe allergic reaction would usually occur within a few minutes

Page 9: COVID-19 Vaccination Packet

to one hour after getting a dose of the Pfizer-BioNTech COVID-19 Vaccine. Signs of a severe allergic reaction can include:

o Difficulty breathing o Swelling of your face and throat o A fast heartbeat o A bad rash all over your body o Dizziness and weakness

Pfizer-BioNTech COVID-19 Vaccine is still being studied in clinical trials. For more information about side effects please see the FDA fact sheet for vaccine recipients. *Adopted from FDA fact sheet for vaccine recipients

- What are the possible side effects of the Moderna COVID-19 vaccine?* Side effects that have been reported with the Moderna COVID-19 Vaccine include:

o Injection site reactions: pain, tenderness and swelling of the lymph nodes in the same arm of the injection, swelling (hardness), and redness

o General side effects: fatigue, headache, muscle pain, joint pain, chills, nausea and vomiting, and fever

There is a remote chance that the Moderna COVID-19 Vaccine could cause a severe allergic reaction. A severe allergic reaction would usually occur within a few minutes to one hour after getting a dose of the Moderna COVID-19 Vaccine. For this reason, your vaccination provider may ask you to stay at the place where you received your vaccine for monitoring after vaccination. Signs of a severe allergic reaction can include:

o Difficulty breathing o Swelling of your face and throat o A fast heartbeat o A bad rash all over your body o Dizziness and weakness

The Moderna COVID-19 Vaccine is still being studied in clinical trials. For more information about side effects please see the fact sheet for vaccine recipients *Adopted from FDA fact sheet for vaccine recipients

- What are the possible side effects of the Janssen/Johnson & Johnson COVID-19 vaccine?* Side effects that have been reported with the Janssen/Johnson & Johnson COVID-19 Vaccine include:

o Injection site reactions: pain, redness of the skin and swelling. o General side effects: headache, feeling very tired, muscle aches, nausea, and fever.

There is a remote chance that the Janssen/Johnson & Johnson COVID-19 vaccine could cause a severe allergic reaction. A severe allergic reaction would usually occur within a few minutes to one hour after getting a dose of the Janssen/Johnson & Johnson COVID-19 vaccine. For this reason, your vaccination provider may ask you to stay at the place where

Page 10: COVID-19 Vaccination Packet

you received your vaccine for monitoring after vaccination. Signs of a severe allergic reaction can include:

o Difficulty breathing o Swelling of your face and throat o A fast heartbeat o A bad rash all over your body o Dizziness and weakness.

The Janssen/Johnson & Johnson COVID-19 vaccine is still being studied in clinical trials. For more information about side effects please see the fact sheet for vaccine recipients. *Adopted from FDA fact sheet for vaccine recipients.

- Can children get the vaccine? Under the Emergency Use Authorizations, the following age groups are authorized to receive vaccination:

o Pfizer-BioNTech: ages ≥16 years o Moderna: ages ≥18 years o Janssen/Johnson & Johnson: ages ≥18 years

Children and adolescents outside of these authorized age groups should not receive the COVID-19 vaccine at this time.

- How is the vaccine administered? The Pfizer COVID-19 vaccine series consists of two doses administered intramuscularly three weeks (21 days) apart. The Moderna vaccine series consists of two doses administered intramuscularly four weeks (28 days) apart. The Janssen/Johnson & Johnson vaccine only requires one dose.

- Why is it important to get both doses of the Pfizer or Moderna vaccines? It is important to complete the 2-dose series in order to optimize protection. Protection from the vaccine is not immediate. It will take one to two weeks following the second dose to be considered fully vaccinated.

- What if I miss my second dose of the vaccine? CDC guidelines allow for up to six weeks between doses to maintain vaccine efficacy. If you go beyond six weeks between doses, you do not need to re-start the series, but you should get the second dose as soon as you can.

- Will I need a “booster” shot after I get the first two-dose series? The need for and timing of booster doses for COVID-19 vaccines has not been established. Vaccine manufacturers are reviewing the duration of efficacy for the vaccine but have not yet determined whether a booster shot is necessary. No additional doses beyond the two-dose primary series are recommended at this time.

- How do I protect myself against the new variant strains of COVID-19? Is CommonSpirit Health changing infection protocols because of the new strains? While we are aware of new variants of the COVID-19 virus, our strategy to address the pandemic has not changed. It remains critically important to wear a mask, wash your hands, and follow social distancing protocols, as well as get the COVID-19 vaccine when it is

Page 11: COVID-19 Vaccination Packet

available to you. Experts believe that the vaccine will protect against new strains of the virus, although more studies are being conducted to determine whether a booster shot will need to be administered to improve immune response, just as we do with other viruses such as the measles. The COVID-19 virus will likely be with us for a long time and we will need to remain vigilant in protecting against its spread through public safety measures, masking, and vaccinations.

- Does the vaccine offer any benefit if I have a history of COVID-19 infection and have a high antibody count? Yes, the vaccine does offer additional benefit as it is currently unknown how long natural immunity from infection lasts. As antibodies from natural infection decrease over time the Centers for Disease Control and Prevention (CDC) recommends vaccination as it has shown to be highly effective with a good safety profile. Therefore, it is recommended to get the vaccine, even if you have had COVID-19 infection. However, if you have had allergic reactions to vaccines in the past or allergic reactions to any of the ingredients, then it is NOT recommended for you to have the vaccine. If you have concerning health issues, please discuss with your primary physician.

- Should individuals with a history of COVID-19 infection be offered the vaccine? Yes, a COVID-19 vaccine should be offered to individuals with prior history of COVID-19 infection that have fully recovered (no longer in quarantine, no longer contagious, but may have lingering symptoms). If you have other health issues and concerns about the vaccine, contact your primary physician.

- I do not have any symptoms. Should I get tested for COVID-19 infection before I take the vaccine? No, testing to assess for acute or prior infection solely for the purposes of vaccine decision-making is not recommended.

- If I have an active COVID-19 infection, can I get the vaccine before I fully recover?

No, vaccination of persons with known current infection will be deferred until the person has recovered from the acute illness (if the person had symptoms) and criteria have been met for them to discontinue quarantine.

- Can I get the COVID-19 vaccine and another vaccine (e.g. Flu, Shingles, Tdap) at the same time? The COVID-19 vaccine should be administered alone with a minimum interval of 14 days before or after administration of any other vaccines.

- Should I get the vaccine if I was exposed to someone with COVID-19?

If you were exposed to someone with COVID-19, wait to get vaccinated until your quarantine period has ended to avoid potentially exposing those around you.

- If I received monoclonal antibodies or convalescent plasma to treat COVID-19, should I get the vaccine? Currently there are no data on safety or efficacy of COVID-19 vaccination in persons who received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment.

Page 12: COVID-19 Vaccination Packet

Patients should wait 90 days before getting the vaccine to avoid interference of the treatment with the vaccine-induced immune response.

- Should pregnant women get the vaccine? While the decision to vaccinate is a personal one, it is recommended that pregnant women consider receiving the COVID-19 vaccine. According to the CDC, pregnant women are at an increased risk for severe illness from COVID-19, including illness that results in ICU admission, mechanical ventilation, and death, compared to their like age non-pregnant peers. Additionally, pregnant women with COVID-19 might be at increased risk for other adverse outcomes, such as preterm birth (delivering the baby earlier than 37 weeks). While pregnant women were not part of the clinical trials for the COVID-19 vaccines, there is no evidence to suggest that these vaccines would be unsafe for pregnant women. The vaccines do not contain a live virus so it is not possible that the vaccine would cause COVID-19 either in the mother or her child. Additionally, it is well known that the antibodies formed in a woman during pregnancy do help to develop immune responses in her unborn child prior to birth. If pregnant women are part of a group that is recommended to receive a COVID-19 vaccine (e.g., healthcare personnel), they may choose to be vaccinated. A conversation between the patient and their clinical team may assist with decisions regarding the use of a COVID-19 vaccine. Those who are trying to become pregnant do not need to avoid pregnancy after COVID-19 vaccination.

- Should women who are breastfeeding or plan to breastfeed be vaccinated against COVID-19? There are no data to suggest that breastfeeding mothers should not receive the COVID-19 vaccines. Antibodies are passed through the mother’s milk and help to develop immune responses in her child. While the vaccines are still not recommended for children as they were not part of the clinical trials, there is no evidence to suggest that breastfed infants/children would be adversely impacted by the milk of a COVID-vaccinated mother.

- Should I be tested for pregnancy before receiving the COVID-19 vaccine? No, there is no recommendation for routine pregnancy testing before receipt of a COVID-19 vaccine.

- Can I still try to become pregnant after being vaccinated against COVID-19? Yes, there is no evidence to suggest that the COVID-19 vaccines have any impact on fertility or the fetus of a vaccinated mother.

- Do I need to wear multiple masks to prevent against COVID-19 infection? The simple answer is yes if the mask you wear (e.g. cloth, disposable, ear-loop) does not have the multiple layers of protection found in other masks such as a KN95 or N95 mask. As a result of new information from the CDC which states that a well-fitted, multiple layer mask provides over 90% protection against airborne particles compared to a loose-fitting, single layer mask which only offers 42% protection, CommonSpirit Health has revised its masking guidelines for employees, patients, and visitors.

Page 13: COVID-19 Vaccination Packet

As a result, each division will be establishing its own practices to reflect CSH’s guidelines and these include changes in the masks patients and visitors will be asked to wear when entering the facility. For example, members of the public who present to a facility in a cloth mask will be asked to wear a standard ear-loop mask underneath their cloth mask and this will be provided by the facility. Additionally, for those who come to our facility in a disposable mask, they will be provided with a replacement, hospital-approved mask to wear instead.

Please contact your supervisor to better understand the masking guidance and how it relates to you and your role in the facility. For more information on the CDC’s masking recommendations, click here.

Additional Information

Additional information on COVID-19 vaccine development, safety and distribution is available here:

• FDA: https://www.fda.gov/vaccines-blood-biologics/vaccines/emergency-use-authorization-vaccines-explained

• CDC: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html • ACOG: https://www.acog.org/clinical/clinical-guidance/practice-

advisory/articles/2020/12/vaccinating-pregnant-and-lactating-patients-against-covid-19 • ACIP Recommendations: Pfizer | Moderna | Janssen/Johnson & Johnson

Additional information about the Emergency Use Authorization (EUA) is available here:

• EUA: Pfizer | Moderna | Janssen/Johnson & Johnson • Fact sheet for Providers: Pfizer | Moderna | Janssen/Johnson & Johnson • Fact sheet for Recipients: Pfizer | Moderna | Janssen/Johnson & Johnson

Page 14: COVID-19 Vaccination Packet

Get vaccinated. Get your smartphone.Get started with v-safe.

10:18 AM

What is v-safe?V-safe is a smartphone-based tool that uses text messaging andweb surveys to provide personalized health check-ins after youreceive a COVID-19 vaccination. Through v-safe, you can quicklytell CDC if you have any side effects after getting the COVID-19vaccine. Depending on your answers, someone from CDC may callto check on you. And v-safe will remind you to get your secondCOVID-19 vaccine dose if you need one.

Your participation in CDC’s v-safe makes a difference — it helps keep COVID-19 vaccines safe.

How can I participate?Once you get a COVID-19 vaccine, you can enroll in v-safe using your smartphone. Participation is voluntary and you can opt out at any time. You will receive text messages from v-safe around 2 p.m. local time. To opt out, simply text “STOP” when v-safe sends you a text message. You can also start v-safe again by texting “START.”

How long do v-safe check-ins last?During the first week after you get your vaccine, v-safe will send you a text message each day to ask how you are doing. Then you will get check-in messages once a week for up to 5 weeks. The questions v-safe asks should take less than 5 minutes to answer. If you need a second dose of vaccine, v-safe will provide a new 6-week check-in process so you can share your second-dosevaccine experience as well. You’ll also receive check-ins 3, 6, and12 months after your final dose of vaccine.

Is my health information safe?Yes. Your personal information in v-safe is protected so that it stays confidential and private.*

10:18 AM

Use your smartphone to tell CDC about

any side effects after getting the COVID-19

vaccine. You’ll also get reminders if you need a second vaccine dose.

Sign up with your smartphone’s browser at

vsafe.cdc.gov

ORAim your smartphone’s

camera at this code

* To the extent v-safe uses existing information systems managed by CDC, FDA, and other federalagencies, the systems employ strict security measures appropriate for the data’s level of sensitivity.

12/11/20

SM

Page 15: COVID-19 Vaccination Packet

How to register and use v-safeYou will need your smartphone and information about the COVID-19 vaccine you received. This information can be found on your vaccination record card; if you cannot find your card, please contact your healthcare provider.

Register1. Go to the v-safe website using one of the two options below:

Complete a v-safe health check-in1. When you receive a v-safe check-in text message on your smartphone, click the link when ready.

2. Follow the instructions to complete the check-in.

ORUse your smartphone’s

browser to go to

vsafe.cdc.gov

Aim your smartphone’s camera at this code

TroubleshootingHow can I come back and finish a check-in later if I’m interrupted?� Click the link in the text message reminder to restart

and complete your check-in.

How do I update my vaccine information after my second COVID-19 vaccine dose?� V-safe will automatically ask you to update your

second dose information. Just follow the instructions.

Need help with v-safe?Call 800-CDC-INFO (800-232-4636)TTY 888-232-6348Open 24 hours, 7 days a weekVisit www.cdc.gov/vsafe

U.S. Department of Health and Human Services Centers for Disease Control and Prevention

2. Read the instructions. Click Get Started.

3. Enter your name, mobile number, and other requested information. Click Register.

4. You will receive a text message with a verification code on your smartphone. Enter the code inv-safe and click Verify.

5. At the top of the screen, click Enter vaccine information.

6. Select which COVID-19 vaccine you received (found on your vaccination record card; if you cannotfind your card, please contact your healthcare provider). Then enter the date you were vaccinated.Click Next.

7. Review your vaccine information. If correct, click Submit. If not, click Go Back.8. Congrats! You’re all set! If you complete your registration before 2 p.m. local time, v-safe will start

your initial health check-in around 2 p.m. that day. If you register after 2 p.m., v-safe will start yourinitial health check-in immediately after you register — just follow the instructions.You will receive a reminder text message from v-safe when it’s time for the next check-in — around2 p.m. local time. Just click the link in the text message to start the check-in.

Page 16: COVID-19 Vaccination Packet

12/01/20

Sign up with your smartphone’s browser at

vsafe.cdc.gov

ORAim your smartphone’s

camera at this code

Use your smartphone to tell CDC about any side effects after getting the COVID-19 vaccine. You’ll also get reminders if you need a second vaccine dose.

Get vaccinated. Get your smartphone.Get started with v-safe.

10:18 AM

10:18 AM

U.S. Department of Health and Human Services Centers for Disease Control and Prevention

Learn more about v-safe www.cdc.gov/vsafe