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Ther tracking systems are also acceptable. For each dose given to an adult, mark off a number in the appropriate age group. Use a second sheet when needed. DO NOT SUBMIT THIS FORM TO THE IMMUNIZATION PROGRAM; TRANSFER THE INFORMATION TO THE VACCINE ACCOUNTABILITY AND ORDER FORM. 19 -- 49 Year 50 -- 64 Year 65 Years Usage PPV-23 1 2 3 4 5 9 13 17 6 10 14 18 7 11 15 19 8 12 16 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 5.

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