Central Michigan District Healt Department
School-based H1N1 Flu Shot Clinic Information
October 29, 2009
October 19, 2009
Dear Isabella County Parents/Guardians:
The novel 2009 H1N1 influenza virus has caused illness ranging from
mild to severe, including hospitalizations and deaths in adults and
children. Health officials are recommending that children and young
adults ages 6 months – 24 years be vaccinated against the novel
2009 H1N1 influenza as soon as the vaccine becomes available.
Immunizing your child is the best way to protect him/her from this
potentially serious disease. Central Michigan District Health
Department is working with schools to offer school-based mass
vaccination clinics for daycare, preschool and school-aged
children. The following clinics are being offered in Isabella
County:
Tuesday, November 3rd from 1:00
p.m. to 7:00 p.m. at
Mt. Pleasant High School (1155 S. Elizabeth St., Mt. Pleasant)
Thursday, November 12th from 1:00 p.m. to 7:00 p.m. at
Beal City High School (3117 Elias Rd., Beal City)
Friday, November 13th from 1:00 p.m. to 7:00 p.m. at
Shepherd High School (100 Hall St., Shepherd)
Children who are between the ages of 6 months and 9 years will need
two doses of vaccine spaced at least 4 weeks apart. The second dose
for these children will be scheduled at a later date. There will be
no cost to you for this vaccine; however, if you have an insurance
plan which covers administration fees for vaccines, we are able to
bill your insurance.
In order for your child to be immunized you must:
• Review the Vaccine Information Sheet (VIS)
• Complete the attached consent/refusal form. This form needs to be
returned whether you choose to have your child immunized or
not.
• Consent/refusal forms must be returned one week prior to the
clinic date in those school districts where clinics will be held to
assist the health department with clinic planning.
• If your child will be attending a clinic within his/her own
school district, then the consent/refusal form can be returned to
your school office.
• If the clinic is not in your school district, bring your child’s
consent on the day of the clinic.
• At this time, we can only immunize daycare aged children, school
aged children and pregnant women. Once the vaccine becomes more
widely available, we will provide community-based clinics in your
area.
If you have questions about the vaccine or the immunization
clinics, please call (989) 773-5921 ext. 8405. You will find more
information on the 2009 novel H1N1 influenza virus, including the
VIS and consent/refusal forms, on our website at www.cmdhd.org.
Your child’s healthcare provider can also answer your questions
about the 2009 novel H1N1 influenza virus and may be able to give
your child both the seasonal influenza and 2009 H1N1
immunizations.
Sincerely,
Mary Kushion, MSA, Health Officer
H1N1
CONSENT TO VACCINATE FORM
H1N1
FLU SHOT INFORMATION SHEET
SEASONAL
H1N1 GUIDE FOR PARENTS

