H1N1 SECONDARY STUDENTS “CLINIC” PLAN

UHS - Tuesday, December 15

CFPMS - Wednesday, December 16

Greetings Parents, Guardians and Students,

The following information contains the details for administering the H1N1 nasal spray live vaccine, manufactured by MedImmune, to our healthy middle and high school students. Unionville High School students will be able to receive the vaccine on Tuesday, December 15th and Patton Middle School students on Wednesday, December 16th. This will be accomplished primarily during the school day each day. As a reminder, the injectable vaccine was offered to all K-12 high risk students at our clinic on November 23rd and WILL NOT be offered to our secondary students during these two days.

Process to be followed:

1. Please link to the Consent form, download and complete - parent signature required for all students. (if needed, hard copies available in the nurse’s office)
2. Consent form due date to high school homeroom teacher / middle school Prime Time teacher is no later than Tuesday, December 8th.
3. Please read the Vaccination Information Sheet (VIS) for the live vaccine.
4. Unionville High School vaccination administration plan:
   1. Unionville High School Nurse’s office – before, during and after school times
   2. Before school 6:45am – 7:30am, between classes, during lunch, during study hall, 2:30pm - 3:30pm.
5. Patton Middle School vaccination administration plan:
   1. Patton Middle School Nurse’s office – exclusively during the school day.
   2. Students receiving vaccination will be called down by team per schedule established in advance.

Thank you in advance for your cooperation in making this a successful event for our students. If you have questions, please contact Jim Fulginiti, UCFSD Director of Student Life (610) 347-0970 x3336.

Consent and VIS Forms

• Consent Form
• VIS for Nasal Spray