Small Town Values; Big World Opportunities | (920) 487-7001 | 1715 Division St. Algoma, WI 54201

ASD Immunization Clinic April 10, 2018



ASD Immunization Clinic April 10, 2018

The Wisconsin student immunization law requires:

  • 1 dose of tetanus, diphtheria and acellular pertussis (Tdap) vaccine for students entering 6th  grade.

To assist parents in meeting this requirement, the Kewaunee County Public Health Department will hold a Tdap immunization clinic at the Algoma schools on Tuesday, April 10, 2018.

In addition, we will also offer Menveo, a meningococcal vaccine. This vaccine is not required by school law, but is recommended for all children over the age of 10. It helps prevent meningitis (serogroups A,C,W, and Y).

If you want your child to receive either vaccination at school, please read the Vaccine Information Statements (VIS)  (Links below) carefully, sign and return the Authorization to Receive form (form F-42029) to your child’s school by Friday, April 6, 2018.  The VIS sheets explain why people should get these vaccines, who should delay getting them and who should not get them at all.

A Student Immunization Record is (link below) for parents who do NOT want their child to receive vaccines at school.  Please complete, sign and return the Student Immunization Record to your child’s school if:

  • Your child has already received the vaccines – record the date(s) of the immunization(s) in the bold outlined box(es)
  • You prefer to have your child immunized by his/her doctor – record the date(s) of the immunization(s) in the bold outlined box(es) after your child is immunized.
  • You want to claim a waiver for religious or personal conviction reasons – check the appropriate box.
  • You want to claim a waiver for medical reasons – check the appropriate box and have the form signed by your child’s doctor.

The vaccines will be administered beginning at 2 pm at AES then after that at AHS. Tdap and Meningococcal offered for Free.

Contact Nurse Becky with questions.

Forms and Information Sheets
Vaccine Information Statement: Meningococcal ACWY Vaccines
HOJA DE INFORMACIÓN SOBRE VACUNAS: Vacunas antimeningocócicas ACWY

Vaccine Information Statement: Tdap Vaccine
HOJA DE INFORMACIÓN SOBRE VACUNAS: Vacuna Tdap

Authorization To Receive Tetanus, diphtheria, acellular pertussis (Tdap) and/or Meningococcal Vaccine(s) (Form F-42029)
REGISTRO DE ADMINISTRACIÓN DE VACUNAS (Form F-44702S)

Student Immunization Record (Form DPH 4020L)
REGISTRO DE VACUNAS DEL ESTUDIANTE (Form DPH 4020S)