The COVID-19 Moderna Vaccine was approved for Emergency use Authorization (EUA) for ages 18 and older. This means that we will be getting the Moderna Vaccine. Please take a few minutes to fill out this short application. The purpose of this application is so that the CTCLUSI Health Department can gather data on who would like the COVID-19 vaccine. This data will be used to set up appointment times, and keep those who want the vaccine informed.
Disclaimer: CTCLUSI is getting a very limited supply of the COVID-19 vaccines for the first distribution, yet expect to receive more vaccines when available. The second distribution of vaccines is unknown. It is our goal to make sure that everyone that wants the vaccine has the opportunity to receive it. There are 10 doses of vaccine in each vial, and once a vial is punctured it is only is good for 6 hours, it will then be disposed of if not used. Due to this, having a list of names and contact numbers will help to prevent the waste of the vaccine if someone is unable to receive it. The vaccine is a two dose vaccine, the second dose is 28 days apart from the first dose.
***Disclaimer: Consent form must be filled out and dated for the day the vaccine is available and administered. Forms are available at the vaccine site to fill out. (updated 1/12/21)