Meningitis

  • Meningococcal Meningitis Vaccination Response Form

    New York State Public Health Law requires that a parent or guardian of campers who attend an overnight children’s camp for seven or more consecutive nights, complete and return the following form to the camp.

    Check one box and sign below.

    [Note: If your child received the meningococcal vaccine available before February 2005 called Menomune™, please note this vaccine’s protection lasts for approximately 3 to 5 years. Revaccination with the new conjugate vaccine called Menactra™ should be considered within 3-5 years after receiving Menomune™.]
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  • Date Format: MM slash DD slash YYYY