Healthcare Personnel (HCP) Flu Vaccination

HCP Vaccination Module: Influenza Vaccination Summary Protocol – March 2020 pdf icon[PDF – 350 KB]

• Introduction to HPS Component pdf icon[PDF – 350 KB]
• Monthly Reporting Plan pdf icon[PDF – 350 KB]
• Influenza Vaccination Summary pdf icon[PDF – 350 KB]
• Key Terms pdf icon[PDF – 350 KB]
• Appendix A – List of Contracted HCP pdf icon[PDF – 350 KB]

Supporting Chapters

• CDC Location Labels and Location Descriptions – January 2021 pdf icon[PDF – 1 MB]

All Data Collection Forms are Print-only

Weekly Reporting

• Weekly HCP Influenza Vaccination Summary Form for non-LTCFs (57.211) – November 2020 pdf icon[PDF – 150 KB]
  • Customizable form word icon[DOCX – 50 KB]
  • Table of Instructions pdf icon[PDF – 200 KB]

Annual Reporting

Monthly Reporting Plan

• HPS Monthly Reporting Plan Form – March 2020 (57.203) pdf icon[PDF – 80 KB]
  • Customizable form word icon[DOCX – 50 KB]
  • Table of Instructions pdf icon[PDF – 50 KB]

Vaccination Summary

• HCP Influenza Vaccination Summary Form – March 2020 (57.214) pdf icon[PDF – 150 KB]
  • Customizable form word icon[DOCX – 40 KB]
  • Table of Instructions pdf icon[PDF – 60 KB]

Seasonal Survey

• Seasonal Survey on Influenza Vaccination Programs for HCP – March 2020 (57.215) pdf icon[PDF – 110 KB]
  • Customizable form word icon[DOCX – 40 KB]
  • Table of Instructions pdf icon[PDF – 160 KB]