The Immunization Action Coalition (IAC) has developed influenza screening forms, which have been reviewed by CDC and which can be used for both seasonal and pandemic H1N1 influenza vaccination:
1. IAC’s "Screening Questionnaire for Injectable Influenza Vaccination," all references to "TIV" (trivalent influenza vaccine) were changed to "inactivated injectable influenza vaccine." This piece can now be used for screening for both seasonal and H1N1 vaccination. To access the revised "Screening Questionnaire for Injectable Influenza Vaccination," go to: http://www.immunize.org/catg.d/p4066.pdf
2. IAC’s "Screening Questionnaire for Intranasal Influenza Vaccination" was revised to include information about use of seasonal influenza and H1N1 influenza live vaccines on the second page (i.e., the two live influenza vaccines should not be given together; if only live influenza vaccines are available, they should be separated by 4 weeks). This piece can now be used for screening for both seasonal and H1N1 vaccination. To access the revised "Screening Questionnaire for Intranasal Influenza Vaccination," go to: http://www.immunize.org/catg.d/p4067.pdf
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