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Documentation of Tdap Administration Optional Form for Health Care Providers STUDENT NAME (Last, First, Middle) DATE OF Tdap NAME OF CHILD S PHYSICIAN OR AGENCY WHERE Tdap ADMINISTERED MM / DD / 2.

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Document each patient's vaccine administration information and follow up in the following places: Medical record: Record the date the vaccine was administered, the manufacturer and lot number, the vaccination site and route, and the name and title of the person administering the vaccine.

Vaccines given IM (intramuscular) route: DTaP, DT, Hib, hepA, hepB, HPV, IIV, MCV, PCV, rabies, Td, Tdap and RZV (Shingrix). Administer IPV and PPSV vaccines either via IM or SQ (subcutaneous) route.

Children younger than 7 years of age receive DTaP or DT, while older children and adults receive Tdap and Td. Give infants and children 5 doses of DTaP. Give one dose at each of these ages: 2 months, 4 months, 6 months, 15 through 18 months, and 4 through 6 years.

Subcutaneous Injections A ⅝-inch, 23- to 25-gauge needle should be inserted into the subcutaneous tissue (Figures 4 and 5) (4).

Administer all diphtheria, tetanus, and pertussis vaccines (DT, DTaP, Td, and Tdap) by the intramuscular route. The preferred injection site in infants and young children is the vastus lateralis muscle of the thigh. The preferred injection site in older children and adults is the deltoid muscle in the upper arm.

Administering a vaccine containing an adjuvant either subcutaneously or intradermally can cause local irritation, induration, skin discoloration, inflammation, and granuloma formation.

Job Aid Date of administration. Vaccine manufacturer. Vaccine lot number. Name and title of the person who administered the vaccine and address of the facility where the permanent record will reside. Vaccine information statement (VIS) Date printed on the VIS. Date the VIS was given to the patient or parent/guardian.

Administer all diphtheria, tetanus, and pertussis vaccines (DT, DTaP, Td, and Tdap) by the intramuscular route. The preferred injection site in infants and young children is the vastus lateralis muscle of the thigh. The preferred injection site in older children and adults is the deltoid muscle in the upper arm.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232