Survey Text

1991
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1991
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1. Transcribe from shot record

Immunization: HIB (shot)

3rd Shot:
Months ____
Day ____
Year 19 ____

b. At what age(s) did -- receive (additional) -- vaccine(s)?

An HIB shot? (This is for meningitis and called Haemophilus influenzae (HA-MA-FI-LUS IN-FLU-EN-ZI) HIB vaccine or H. Flu vaccine)

3rd

Age ____
1[] Months
2[] Years