Covid-19 Booster Dose Vaccination Consent Form for Pfizer/BioNTech (Comirnaty)

We are now offering the Comirnaty Original/Omicron BA.4-5 (15/15 micrograms)/dose dispersion for injection COVID-19 mRNA Vaccine (nucleoside modified) in Rosscarbery Pharmacy for 1st booster dose (all cohorts over 12 years)

2nd booster dose for the following cohorts; ages >18years, healthcare workers, pregnancy, for people aged 12-49 with a weak immune system.

3rd booster dose for over 65 years and those who are immunocompromised.

 

If you have not been contacted by Rosscarbery Pharmacy with a date for your vaccination OR you would like to be added for our waiting list, CALL 083-4397126. 

Before filling out this consent form, you MUST read the following information regarding Comirnaty Original/Omicron BA.4-5 (15/15 micrograms)/dose dispersion for injectionCovid-19 Booster Vaccine. 

Package leaflet: Information for the user: Comirnaty Original/Omicron BA.4-5 (15/15 micrograms)/dose dispersion for injection Adults and adolescents from 12 years COVID-19 mRNA Vaccine (nucleoside modified) tozinameran/riltozinameran(pages 255-264)

Comirnaty (Pfizer/ BioNTech) vaccine for children and young people aged 12 to 15 Important information for parents and guardians

Important information on your COVID vaccines for people age 50 and over and between 16 and 49 with a health condition

HSE Information leaflet for Covid-19 booster in pregnancy

HSE Covid-19 booster Information for Healthcare workers

HSE Information on Covid-19 vaccines for people aged 16 and over

Living with COVID-19 if you have a weak immune system