Influenza Toolkit - Plan the Campaign

Action Resource

Review what was done last year

Post Campaign Assessment Worksheet word* (24.5kb)

Review list of materials & other considerations prior to the clinic

Campaign Considerations word* (30.0kb)

Review strategies & best practices utilized by other influenza campaigns

Strategies to Improve Health Care Worker Vaccination word* (29.0kb)

Assemble materials

Instructions for Use of Vaccine Information Statements pdf* (83kb)

 VIS: TIV pdf* (478kb)

 VIS: LAIV pdf* (83kb)

Standing Orders for Administering Influenza Vaccine to Adults pdf (63kb)

Declination of Influenza Vaccination pdf* (22.36kb)

Vaccine Administration Record for Adults pdf* (80.88kb)

Screening Questionnaire for Adult Immunization: Injectable Influenza Vaccination pdf* (75.02kb) & Intranasal Influenza Vaccination pdf* (86.23kb)

Vaccine Adverse Event Reporting System (VAERS) Letter pdf* (635.57kb) & Brochure pdf* (375.92kb)

Suggested Supplies Checklist for Immunization Clinic pdf* (2.27mb)

Roster Sheet for Influenza Clinic word* (21.5kb)

Sustain the campaign

Planning and Implementing an Employee Immunization Campaign Checklist word* (35.0kb)