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Completed
Deferred / Other
IAP Schedule
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Vaccine
Dose
Date & Time
Brand Name
Manufacturer
Batch / Lot No.
Expiry Date
Route
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Intramuscular (IM)
Subcutaneous (SC)
Intradermal (ID)
Oral
Site
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Right thigh (anterolateral)
Left thigh (anterolateral)
Right deltoid
Left deltoid
Left upper arm
Right upper arm
Oral
Administered By
Adverse Event?
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Yes
Adverse Event Details
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Vaccine
Status
Deferred
Contraindicated
Not Applicable
Reason