Pneumonia Vaccination

If you have been invited by text to have a pneumonia vaccination, click here :

Patients aged 65+ are recommended to have a pneumonia vaccination. Most patients need one vaccination per lifetime.

Patients with certain medical conditions are recommended to have a pneumonia vaccination and some of those need a booster every 5 years.

Pneumonia vaccination is built in to the childhood vaccination programme.

More information can be found at:

www.nhs.uk/Conditions/vaccinations/Pages/pneumococcal-vaccination.aspx

Pneumonia is a serious disease – more information can be found at:

www.nhs.uk/video/Pages/Pneumococcaldisease.aspx

If you are aged 65+ or have been invited for vaccination and do not wish to have the vaccination, please complete the form below and we will amend your records:

Pneumonia Vaccination

Are you aged 65+ or have you been invited for vaccination? *

Yes

Please check with the surgery if you are eligible on medical grounds for a pneumonia vaccination.

Have you ever had a pneumonia vaccination? *

Yes

Please tell us when and who gave (ie surgery name) the vaccination:

Would you like a vaccination? *

Yes

Most patients only need 1 vaccination per lifetime, if you think you need a 5 year booster on medical grounds, please check with the surgery.

If you would like a vaccination, please contact the surgery for a nurse appointment.

Please complete the form below and we will note this on your records.

Name:

Date of Birth: *

Email address: *

Do you have any communication/information needs relating to disability, impairment or sensory loss?

Yes

Please be specific:

I do not wish to receive a pneumonia vaccination

(You are free to change your mind at any time)

Pneumonia Vaccination

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