Vaccination & Treatment

Sample COVID-19 Vaccination Policy with Standing Order

Sample Influenza Vaccination Policy with Standing Order 

Sample RSV Vaccination Policy with Standing Order

Sample Paxlovid (nirmatrelvir/ritonavir) Policy

Sample Lagevrio (molnupiravir) Policy

Sample Letter to Families about Influenza and COVID-19 Vaccination and Treatment

Sample COVID-19 Vaccine Consent Form

Sample Influenza Vaccine Consent Form

Suggested phrase for documenting RSV Shared Decision Making:  The resident/Health Care Proxy(HCP)/medical decision maker and I engaged in a shared decision-making conversation regarding the respiratory syncytial virus (RSV) vaccination. We discussed risk vs. benefit, RSV vaccine information/facts, clarified the resident’s treatment preferences, and I answered and reviewed all questions and concerns. We agreed to the following vaccination treatment plan: (specify either vaccination acceptance or declination) and the resident/HCP/medical decision maker signed the applicable consent form and acknowledgement of shared decision making.

Vaccine Information Statements and other resources are available at www.immunize.org.

Additional information is available from the CDC at https://www.cdc.gov/vaccines/covid-19/index.html.