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Mitti by SafetyCulture
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COVID-19 Vaccine Screening Checklist

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This COVID-19 vaccine screening checklist, adapted from the CDC Prevaccination Checklist for COVID-19 Vaccines, helps clinicians determine if a person should receive a vaccine dose today. It guides assessment of current illness, prior COVID-19 vaccination, allergic reactions to PEG or polysorbate, reactions to previous doses, recent vaccinations, prior COVID-19 infection and antibody therapy, bleeding disorders or anticoagulant use, immunocompromising conditions or therapies, pregnancy and breastfeeding, and the presence of dermal fillers. Use it to document responses and identify contraindications or precautions before vaccination.

With Mitti you can

Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
Create and share professional reports instantly
Confirm accountability and compliance with a digital log

With Mitti you can

Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
Create and share professional reports instantly
Confirm accountability and compliance with a digital log

About author

Mitti (by SafetyCulture) is the operations system for every site, shift and standard. Trusted by 80,000 organizations in 190 countries, Mitti publishes free checklists, SOP templates, audit checklists and toolbox talk topics that turn paper processes into a digital audit trail. Download one, put it to work on your next inspection or shift, and see why teams keep coming back for more.