Brazoria County Flu
Public Health Preparedness and Response
Brazoria County Health Department
There are two different forms of vaccine being offered in the community events, depending on supply availability: FluMist intranasal vaccine and injectable vaccine. In order for you to determine which form of vaccine is right for you, review the checklist below. Afterward, download the right consent form, print and complete it, and bring it with you to save some time. If you are unable to print, we will have forms available at the different events. If you can answer "true" to the following statements, then you can take the Flu Mist intranasal vaccine: I am 2 to 49 years of age. I have never had a serious reaction after receiving a vaccine. I have never been paralyzed with Guillain-Barre syndrome (an illness with sudden muscle weakness and some loss of senses in the fingers and toes). I do not have a serious allergy to eggs. I do not have a long-term health problem with heart disease, lung disease, asthma, kidney disease, neurologic or neuromuscular disease, liver disease, metabolic disease (e.g., diabetes), or anemia or another blood disorder. If I am less than 5 years of age, in the past 12 months no healthcare provider has ever told me that I have had wheezing or asthma. I do not have a weakened immune system due to illness or long-term treatment. If I am a child or teen, I am not receiving aspirin therapy or aspirin-containing therapy. I am not pregnant or planning to become pregnant within the next month. I have not taken anti-virals (such as Tamiflu or Relenza) within the last 48 hours. I do not live or expect to have close contact with a person whose immune system is severely compromised and who must be in protective isolation (such as hospital room with reverse air flow). I have not received any live vaccinations (such as MMR, Varicella and Flu Mist) in the last 4 weeks. Nasal Mist Vaccine Information Sheet, Screener, and Consent (Spanish) Families & Individuals Schools Day Care Providers & Other Settings Communities & Employers Laboratories News Releases & PHEP Newsletters Training Consent Forms for Vaccination Nasal Mist Vaccine Information Sheet, Screener, and Consent (English) Injectable Vaccine Information Sheet, Screener, and Consent (English) Injectable Vaccine Information Sheet, Screener, and Consent (Spanish)