Justification for Change
Previously, DHA Form 207, “COVID-19 Vaccine Screening and Immunization Documentation” was approved for ages 12 years and older. The Defense Health Agency (DHA) is seeking approval for DHA Form 236, “Pediatric COVID-19 Vaccine Screening and Immunization Documentation” for those 5-11 years in order to document the clinical determination if the COVID-19 vaccine is appropriate for the specific patient.
Although both forms include the same questions, the COVID-19 Vaccine Working Group and DHA Patient Safety Office recommended a separate form in order to mitigate possible vaccination errors when administering to children ages 5-11. Both of these forms are authorized by Public Law 104-191, 10 U.S.C., Chapter Ch. 55, Medical and Dental Care; DHA Interim Procedures Memorandum (IPM) 20-004, “DoD Coronavirus Disease (COVID-19) Vaccination Program Implementation." The DHA Interim Procedures Memorandum 20-004 is the implementation guide for all Military Treatment Facilities (MTF).
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | James, Angela N CIV WHS ESD (US) |
| File Modified | 0000-00-00 |
| File Created | 2021-11-19 |